Jubilee Mews is a care home that provides accommodation and nursing care for a maximum of 12 people with a mental health condition. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Jubilee Mews accommodated 11 people at the time of the inspection. The service operates across four adjoining purpose-built houses, one of the houses is the office for the service.

At our last inspection in March 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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At this inspection we found the service remained good.

People told us they were safe and were well cared for. Staff knew about safeguarding vulnerable adults procedures. Staff were subject to robust recruitment checks. Arrangements for managing people’s medicines were also safe.

People told us their privacy, dignity and confidentiality were maintained. Staff understood the needs of people and care plans and associated documentation were clear and person-centred. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People told us staff were kind and caring and they felt comfortable with all the staff who supported them.

People had food and drink to meet their needs. Support was available for people to plan their menu, shop for the ingredients and cook their own food. People were provided with opportunities to follow their interests and hobbies and they were introduced to new activities. They were all supported to contribute and to be part of the local community.

People and staff spoke well of the registered manager and they said the service had good leadership. Staff were very well supported by the registered manager. The registered manager had a clear vision for the service and its development. Staff were extremely knowledgeable about people's needs. They were enthusiastic and believed passionately in the ethos of the organisation.

There were effective systems to enable people to raise complaints, and to assess and monitor the quality of the service. People told us they would feel confident to speak to staff about any concerns if they needed to.

Staff upheld people's human rights and treated everyone with great respect and dignity.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Further information is in the detailed findings below.

We carried out an inspection of Jubilee Mews on 3, 9 and 10 March 2016. The first day of the inspection was unannounced. We last inspected Jubilee Mews in June 2014 and found the service was meeting the relevant regulations in force at that time.

Jubilee Mews is a care home that provides accommodation and care for up to 12 people with nursing and personal care needs related to their mental health. At the time of the inspection there were 11 people accommodated there.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People told us they felt safe and were well cared for. Staff took steps to safeguarding vulnerable adults and promoted their human rights. Incidents and alerts were dealt with appropriately, which helped to keep people safe.

The building was safe and well maintained. Most areas of the home were clean. One bathroom required refurbishment to enable more effective cleaning and odour control. Risks associated with the building and working practices were assessed and suitable steps taken to reduce the likelihood of harm occurring. This was balanced with the need to allow people to take measured risk as part of the programme of rehabilitation and development of skills and strategies to live independently.

We observed staff act in a courteous, professional and safe manner when supporting people. At the time of our inspection, the levels of staff on duty were sufficient to safely meet people’s needs. New staff were subject to thorough recruitment checks. There was little turnover of staff.

Medicines were managed safely for people and records completed correctly. People received the support they needed to manage medicines for themselves, so they were taken as prescribed.

As Jubilee Mews is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate policies and procedures were in place and the registered manager was familiar with the processes involved in the application for a DoLS. There were no DoLS in place at the time of our inspection, although the input of relevant professionals was being sought where one was being considered. Arrangements were in place to assess people’s mental capacity and to identify if decisions needed to be taken on behalf of a person in their best interests. Staff obtained people’s consent before providing care.

Staff had completed safety and care related training relevant to their role and the needs of people using the service. Further training was planned. Staff were well supported by the registered manager.

Staff were aware of people’s nutritional needs and people were supported to be independent in this area. Where needed, staff supported people with budgeting, meal planning and preparation. People’s health needs were identified and external professionals involved if necessary. This ensured people’s general medical needs were met promptly.

People accessed community based activities and occupation and were able to come and go freely. We observed staff interacting positively with people. We saw staff treated people with respect and explained clearly to us how people’s privacy, dignity and confidences were maintained. Staff understood the needs of people and we saw care plans and associated documentation was clear and person centred.

People using the service and staff spoke well of the registered manager and care provider and felt the service had good leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from external managers.

We considered our inspection findings to answer questions we always ask.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Below is a summary of what we found.

Is the service safe?

All the people we spoke with told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. One person told us, “Oh, yes I do feel safe here. I can go to the staff at any time if I don’t”. Another person told us, “I feel very safe here, especially since I know I can talk to the staff at any time.”

We spoke with staff about Deprivation of Liberty Safeguards (DoLS). The registered manager told us that there had been no applications submitted. They told us they had received training in making an application and showed us the policy and procedures they followed. They told us that some staff had received relevant training and had access to the policy and procedures. Those staff told us that they had received this training.

People told us the home was comfortable. They told us that it was always clean and we saw that the home was well maintained and serviced regularly.

Is the service effective?

Comments from people included, “I decide what I want to do each day. I say to the staff what I would like to do. Today I am going out for a meal at lunchtime.” Another person told us, “The staff are very helpful. I have a keyworker and they have helped me to settle in and organise things.”

People explained how their care and welfare needs were met. People told us they had support with health appointments and felt the service was flexible. One person told us, “The staff have helped me register with a new doctor. I have just had a regular check-up.” Another person told us, “I can have problems with sleeping. The staff have helped me with this. Sometimes I can have terrible headaches. I have new medication for this and I can ask for this when I need it.”

Is the service caring?

We saw staff communicated well with people and were able to explain things in a way which could be easily understood. People were not rushed when care was delivered and we saw staff interactions with people were caring. All the people we spoke with said they felt the care was very good. One person told us, “I chose to come here. I really like it. I like the peace and quiet in this house. The staff are very pleasant. I like it here. I think the staff are very good with you.”

We saw staff treated people with respect and dignity. All the people we spoke with told us they were very happy with the care they received.

Is the service responsive?

All the people we spoke with told us staff would respond to any of their requests for support. One person told us, “I like to go out each week for social things. When I need support the staff will help me. I like someone to come with me sometimes to the shops.” Another person told us, “I am planning to go on holiday in September and staff are supporting me with this.”

All people we spoke with told us they were involved in decisions about their care. They said staff were flexible and responded to their requests promptly. We saw staff responded to people's requests for help in a timely manner.

We saw there was a complaints policy at the home. People told us they found the manager very approachable and would not hesitate to raise any issues or complaints.

People’s care needs had been reviewed at least every six months. We saw when people's requirements had changed the provider had responded appropriately and reviewed the care and support they delivered in line with these changes. Care records had been updated to reflect the person's current needs.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service well-led?

The service had registered manager in post who showed us there was an effective system to regularly assess the quality of service people received. We found the views and opinions of people, relatives and staff had been taken into account.

We saw the home had systems in place which ensured managers and staff learnt from any accidents, complaints, whistleblowing reports or investigations. This helped reduce the risks to people and helped the service to continually improve.

Staff told us they understood their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place.

At the time of the inspection there were eleven people who used the service and we were able to meet and speak with some of them about their experiences of care and support at Jubilee Mews. We also spoke to relatives of people who used the service, with the four staff on duty and external visitors. One person who used the service told us, “I have lived here for a while and I am very happy.” Another person told us, “I like it here and I have a good keyworker”.

We were able to observe the experiences of people who used the service. For instance, we spent time with people as they managed their day to day activities, such as cooking and going out. We observed how staff supported and encouraged people who used the service with these daily activities. We saw staff understood each person’s different needs, for example, when they required additional support with going out to appointments or social activities.

We saw the staff supported people to make choices about how they spent their day. People told us they like to go out independently in the community and used the local facilities.

We saw that staff treated people with dignity and respect. We saw that people had freedom of movement around their home and could spend time in their bedrooms whenever they wanted. We saw that each person had their own bedroom which was personalised. Each person had their own keys to the property and their room and exercised choice and control about their daily lives. We observed that staff respected people’s privacy and knocked before they entered their rooms.

We saw that the staff communicated well and appropriately with people in a way that was easily understood. We saw that staff was attentive and interacted well with people.

We learned more about how care and treatment was provided when we talked with staff, observed their practices and looked at the records of four people who used the service. One staff member told us, “We are a very close team and we support each other and we learn from each other.”

“I am happy here; I am able to talk to the staff if I need to. We usually have house meetings and we sort everything out together. If there are things we are not happy about we will change it.”

“I am fine here. I like the staff.”

“I like to do my own cooking; I have lived here for several years.”

We found that before people received any care or treatment they were asked for their consent and the provider had acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

We found that people who used the service were protected and safe. We found that there was an effective infection control system in place and that the home had a clean and suitable environment.

We found that people who used the service had their care and welfare needs met.

We found that people’s views were important and listened to. We found that there was an effective complaints system in place.

People told us they were involved in assessing what their needs were and how those needs were to be met. They also told us they have a good amount of choice and independence in their daily lives.

They told us they were happy with their care. Comments included, “We’re treated fairly. My key worker listens to me”; “There’s nothing I don’t like”; and, “I’m happy enough, here”.

People said they felt safe and relaxed when in the home. Everyone we spoke with said they trusted the staff to look after them and felt they could share any worries they had with the staff. One person said, “They treat you well, and they listen to you”. Nobody told us they had any worries about living in the home.

They said staff listened and responded positively to their views, and provided them with the support they needed.