Juniper House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

Juniper House provides accommodation and care for up to 60 older people, including people that need support because of their physical frailty and those who need professional nursing care because of their medical condition. Additionally the ‘Memory Lane’ section of the home specialises in supporting people living with dementia. Respite care and short breaks are part of the service provided at Juniper House. The home is purpose built and adapted throughout to meet the diverse care needs of the people in residence. There were 59 people in residence when we inspected the service on 24 and 30 November 2017.

At the last inspection on 21 August 2015 the service was rated ‘Good’. At this unannounced inspection we found the service remained ‘Good’.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (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 were safe. People were protected by robust recruitment procedures that made sure people did not receive unsafe care from staff that were unsuited to the job. They were safeguarded from avoidable harm and poor practice by staff that knew what action they needed to take if they suspected this was happening.

People were cared for by sufficient numbers of professional nurses and care staff. People's needs had been assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. They received care from staff that had received training and support to carry out their roles.

The premises and equipment used to provide people with the care they needed were appropriately maintained throughout to ensure their safety. Systems were in place to ensure the premises was kept clean and hygienic so that people were protected by the prevention and control of infection. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

People’s capacity to make informed choices had been assessed and the provider and staff were aware of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support.

People received care and support from staff that knew what was expected of them and they carried out their duties effectively and with compassion. They were treated equally and their individuality was respected by staff.

Risks to people’s safety were reviewed as their needs and dependencies changed. Care plans were personalised and reflected each person’s individual needs and provided staff with the information and guidance they needed to manage risk and keep people safe.

People had access to community healthcare professionals and received timely medical attention when this was needed. There were appropriate arrangements in place for people to have regular healthcare check-ups. Medicines were appropriately and safely managed. Medicines were securely stored and there were suitable arrangements in place for their timely administration by the nurse in charge.

People enjoyed their meals and said they always had enough to eat and drink. Individuals who needed encouragement and support with eating a healthy diet received the help they required.

The provider and registered manager led staff by example and enabled the staff team to deliver individualised care that consistently achieved good outcomes for all peopl

This unannounced inspection took place on the 21 August 2015.

Juniper House provides personal and/or nursing care for up to 60 older people including people with dementia care needs. There were 57 people in residence when we inspected.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (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 were cared for by sufficient numbers of professional nurses and care staff that were experienced and had received the training they needed to do their job safely. People were protected by robust recruitment procedures from receiving unsafe care from staff that were unsuited to the job. Staff knew what was expected of them when caring for older people, including those with dementia care needs, and/or nursing needs and they carried out their duties effectively and with compassion.

People’s nursing and/or care needs had been assessed prior to admission and they each had an agreed care plan. Their care plans were regularly reviewed, reflected their individual needs and provided all staff with the information and guidance they needed to provide person centred care.

People were safe. They were safeguarded from abuse and poor practice by care staff that knew what action they needed to take if they suspected this was happening.

People’s individual preferences for the way they liked to receive their care and support were respected. People were enabled to do things for themselves by friendly care staff that were attentive to each person’s individual needs and understood their capabilities.

People’s individual nutritional needs were assessed, monitored and met with appropriate guidance from healthcare professionals that was acted upon. People had enough to eat and drink. People who needed support with eating and drinking received the help they required.

People’s healthcare needs were met and they received timely treatment from other community based healthcare professionals when this was necessary. People’s medicines were appropriately and safely managed. Medicines were securely stored and there were suitable arrangements in place for their timely administration.

People, and where appropriate, their representatives or significant others were assured that if they were dissatisfied with the quality of the service they would be listened to and that appropriate remedial action would be taken to try to resolve matters to their satisfaction.

People received care from staff that were supported and encouraged by the provider and the registered manager to do a good job caring for older people. The quality of the service provided was regularly audited by the registered manager and the provider and improvements made when necessary.

We spoke with the relatives of one person who used the service, they told us “we are very happy with the care”, they told us that they had time to speak with the manager about any concerns and these had been resolved.

We found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that there had been an improvement in the way that the accidents and incidents were recorded. We found that there was sufficient information recorded about injuries sustained in accidents to inform medical staff of injuries incurred in accidents.

We spoke with five people who lived at Juniper House. They all told us that they liked living at Juniper House and that the staff knew them very well.

We found that people’s needs had been assessed and risks to people’s health and wellbeing had been identified and control measures put in place.

We found that the staff at Juniper House managed the medicines and the quality monitoring of the home well. We saw that staff were recruited appropriately and there were enough staff to meet the needs of the people who used the service.

We found concerns with the way staff monitored people’s health following an accident.

We spoke with one person who looked after their own medicines. They told us they were ‘’happy looking after my medicines’’.

We found that there were some processes in place to ensure the safe use of medicines. However we found that the controlled drugs were not stored in line with regulations. We also saw that that not all medicine records were complete.

We spoke with nine people who used the service who told us they were happy living at Juniper House. One person said they “couldn’t ask for anything else”. Another person said that they were treated well.

We spoke with a relative who was visiting, they said that they were always made to feel welcome, and staff knew how their relative liked their tea.

We spoke with three people who lived at the home, one said that they felt happy living in the home, and the staff treated them as an individual; two other residents said that they were happy in the home and the staff treated them well. However, the staff said that they would have liked more training and supervision.