Jubilee House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were cared for by a consistent staffing team who knew them well. Staff had time to engage with people throughout the day as well as meeting their basic care needs. The management team worked collaboratively with the local authority to ensure any safeguarding concerns were dealt with appropriately. Staff communicated clearly with each other to ensure people’s needs were met and had worked hard to improve people’s health and well-being. This included building their skills to better support people with anxious and distressed behaviours. The environment was safe and clean due to infection prevention and control procedures.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Steps were taken to ensure people were protected from the reoccurrence of incidents, such as falls. Accidents and incidents were reviewed to establish what action could be taken to prevent reoccurrence and if there were any learning points from the incident that staff should reflect on. This created a culture of continuous reviewing and learning which resulted in risks to people being mitigated in order to keep them safe.

Staff fostered a culture of learning new skills to improve the lives of people. One staff member told us all staff had completed dementia training, which they felt was important as lots of people at the home were living with dementia and staff needed the skills to support them effectively. Another staff member said, “We have regular team meetings. We share our problems, what we need to do to make a difference. We can share our opinions." This empowered staff to continue to build upon and further improve the good care that was already being given to people.

There were systems in place to ensure learning was identified from incidents and shared with staff. Staff recorded any accidents or incidents that occurred, and these were reviewed by senior staff to identify any action that could be taken to prevent a similar incident happening again.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and their relatives told us the service made them feel safe and were able to explain how. For example, one person told us, “I feel perfectly safe. I feel very comfortable here.” A relative said, “ I completely trust them. In terms of examples, when I go in three to four times a week they are always present and there’s people around. They care as much about me as much as my mother-in-law. Nothing is too much trouble. They always respond and I trust them 100%.” A further relative told us there loved one had lived in a number of other care homes, saying "He was agitated in his previous places, but here he is very relaxed, which is indicative of how he is feeling."

Staff understood their responsibilities of keeping people safe from the risk of abuse. They were aware of the different types of abuse people may be exposed to, the signs to be aware of and reporting procedures. The registered manager told us, “We are very proactive regarding safeguarding and discuss with staff regularly. Staff know they are responsible for speaking up. Our residents are supported well and I am very visible around the home so residents and their relatives know they can speak with me.” A staff member confirmed to us, “We report to the nurse and manager. We can go to police of the local authority if we think things are not being actioned or are very serious.”

People appeared relaxed and comfortable in the presence of staff. There was an engaging atmosphere with staff always on hand in communal areas. Staff were approachable and took time when speaking with people to ensure people felt listened to.

The registered manager and staff team showed great commitment to ensuring people were safe and any concerns raised were fully reviewed. The service had recently been subject to numerous allegations of safeguarding concerns raised through whistleblowing. Safeguarding concerns were investigated in a systematic and detailed manner, ensuring every single part of the allegation was responded to in detail. When similar concerns had been raised, staff involved had been interviewed multiple times to ensure thoroughness and that nothing was missed. These processes were also provider wide with senior managers not only supporting the registered managers investigations but also interviewing staff and being present at the service to ensure transparency and an open culture. In addition to reviewing safeguarding concerns, the registered manager ensured systems and processes relating to any concerns were fully reviewed with staff to ensure potential lessons were learnt. The local authority was extremely positive regarding how the registered manager reviewed concerns, the level of detail provided within reports and their willingness to work alongside them to support the safeguarding process.

People told us risks involved in their care were managed safely. One person said, “The staff will always do the right thing and that’s why I feel safe. I don’t think about risks as such.” Relatives confirmed this, with one saying, “Staff are very aware of her condition and I can see from the daily and hourly report they fill in how much and how often staff are with her. Not just a popping through the door but actually looking after [person] the whole time.” Another relative told us, “[Staff] really pay attention. They keep a close eye on [person’s] weight. When his needs changed, they were very quick to involve the Speech and Language team. They are really good at trying what will work for that person."

Staff and the management team told us they worked together as a team to reduce the risks to people safety and well-being. The registered manager told us, “ I am so proud of the team and how they have worked to reduce risks. We have a big focus on falls and nutrition, and these have now greatly reduced.” They went on to describe falls had reduced by 60% and the positive impact of systems in place to review nutrition meant people no longer required the use of supplements on a day-to-day basis. These were stated as the main reasons for Surrey care Association awarding the service Care Home of the Year in 2023. Staff reaffirmed this, saying, “We are around for our residents all the time. We have been rewarded for the action we take to reduce falling. We want them to feel happy and safe and we work with their relatives, we work together” and “I know the residents very well. My duty is to check - if they wear glasses, are they wearing their glasses? If they use a frame, are they using it and in the proper way? The small things make a difference.” Another member of staff gave excellent feedback about one of their peers, saying, “[Staff member] is absolutely brilliant; probably one of the best colleagues I have ever worked with. If you ever have a concern about one of the residents, (they) will always take the time to listen.”

Staff understood people’s needs and worked collaboratively with people and their colleagues to support people in a safe and personalised way. We observed people felt comfortable in approaching staff when they required support and staff responded positively. Staff understood the importance of being present in communal areas to support people when required. Staff communicated with people and their colleagues well, informing them of what they were doing. Staff appeared well trained in the way they approached people, speaking to people in a way which was personalised and in line with their needs. Staff clearly knew people well and responded promptly when people needed help. They gave people time to respond and gently guided them in the safest way to do things such as how to get up and how to sit when eating.

Robust risk management systems were embedded into staff practice and the routines of the home. This supported staff in providing safe and effective care to people which had led to a reduction in the number of falls, the number of people at risk of malnutrition and incidents of distressed behaviour. For example, one person was often very distressed, refusing care, and putting themselves and others at risk when they first moved into the service. Because of this they required one to one staff support and anti-psychotic medicines to calm them. Staff took time to learn about the person and their past life which led them to implementing things including a secure tool board which was of interest to the person as they used to work in construction. This consequently led to the one to one support no longer being needed and the use of anti-psychotic medicines reduced as the person’s emotional well-being and psychological needs were now being met. Risks were looked at both at an individual and a service wide level. Care records contained highly detailed risk assessments for people regarding the precautions people required to keep them safe such as the level of observation, support needs, signs of concern, medication reviews and how to communicate with the person. In addition, systems such as where staff updated records, staff breaks, in-house moving and handling and frequent management walk arounds had been reviewed to maximise the time staff were able to spend with people and the support they received. The use of technology had also been increased by fitting sensors to alert staff when people required support and to streamline the time staff spent completing care notes. Daily meetings were held to review any arsing concerns to enable action to minimise risks to be taken swiftly.

People lived in a safe environment. A recent resident quality survey found that 100% of people felt the home was a safe place to live. Relatives echoed this, stating, “It is always clean, neat and tidy. And they just have been painting halls, stairs and landing area. The front garden is always looking nice, flowers blooming.”

In order to maintain the safe environment, the management team had invested in the outdoor areas of the service by replacing the garden furniture and maintaining the landscaping.

We observed the home was clean, hygienic and safe. People had access to the equipment they needed to maintain their mobility and safety, including hoists, slings and adaptations. We observed staff demonstrate safe practice when they supported people to mobilise.

Regular checks and audits were carried out to ensure the home and equipment used in people’s care was safe. This included health and safety and fire safety checks. Risk assessments had been carried out to identify any risks in the use of equipment used in people’s care and measures put in place to mitigate these.

People told us there was a stable staffing team available to support them with their care needs throughout the day. One person said. “There are people there if you need them." A relative confirmed this saying, "There is a very consistent staff team who know their residents really well. We recognise the staff, and the staff recognise us."

Staff echoed this, saying they felt there were enough of them on any shift to provide safe as well as personalised care to people. One staff member said, “We have time to spend with [people] other than providing their care, especially at weekends when we do not have activities. We spend time with them." Staff also confirmed they received regular and beneficial training to enable them to fulfil their job effectively.

We observed that sufficient staff were available to meet people’s needs and keep them safe. People did not have to wait for care and support when they needed it. Staff engaged proactively and positively with people and were caring in their approach. Staff communicated effectively with one another to ensure people received the care they needed. For example, if a member of staff was busy supporting a person and another person said they needed support, the member of staff alerted a colleague. Staff at all levels and from different staff groups worked well together at lunchtime. For example, the lifestyle team helped serve meals and the clinical lead was present to ensure people received their food as they needed it prepared.

The provider used a dependency tool to calculate how many staff were needed on each shift to keep people safe and provide the care they needed. The dependency tool was reviewed regularly to ensure staffing levels continued to reflect people’s needs. Checks were carried out to ensure staff training and supervision was up to date, which ensured staff had access to the information and support they needed to provide safe and effective care. Team meetings were held regularly and were used to ensure staff worked in a consistent way and to provide updates on any changes in people’s needs.

People and their relatives confirmed there were good infection prevention and control processes in place. One person told us, “The home is always clean and hygienic.”

Staff told us they attended training in infection prevention and control in their induction and regular refresher training.

We observed the home was clean, hygienic and safe. This included communal areas and people’s rooms.

Cleaning checklists were completed by the housekeeping team and audits of infection prevention and control were carried out regularly.

People were supported and involved with their medicines in a safe way, with their relatives informed and involved if necessary. One relative told us, “I get monthly reports by phone and any need to change medication I am advised of to make sure I agree with it. I am asked for permission for vaccines.” Another relative described their loved one was currently experiencing a review of their medicines. They told us, “I’m comfortable with them giving medication. We are at a bit of an experimental time at the moment but I don’t have any doubts with the staff doing this.”

Staff knew people well and took time to talk and spend time with them rather than providing just task-based care. This had reduced people’s anxieties and therefore the need for medication to calm them. For example, due to their dementia, one person was known to become anxious about whether they can afford the food, coffee and the charge for accommodation to stay at the home. The staff had written out a letter which explained that the costs were all paid for. Staff told us, "She gets anxious, but then she reads the note and she says it is such a relief." Staff were knowledgeable about people’s needs in relation to their medicines and how they should be managed. They worked alongside healthcare professionals to ensure the best outcomes for people. Staff received training in medicines administration and their competency was assessed. They were aware of the need to share any concerns or errors in relation to people’s medicines to ensure action was taken.

Robust processes were in place to ensure people received their medicines in line with their prescriptions. The service had implemented a number of initiatives to better support people with their medicines which had led to significant improvements in some people’s health and well-being. Examples of good practice highlighted was the reduction in the use of anti-psychotic medicines and as and when needed medications (PRN). The home had appointed and trained champions in identifying and supporting people with distressed behaviour. The champions were in turn passing their skills to other staff members and providing guidance where required. This process had led to a significant reduction in incidents and the use of PRN medicines. The GP told us staff were skilled at identifying any concerns regarding medicines and would raise this promptly to look at what adjustments could be made. This supported people’s safety and well-being. Medicines were stored, monitored and administered safely. Systems were exceptionally organised which had led to very few medicines errors. Staff were confident and knowledgeable regarding the medicines they were administering and demonstrated a skilled approach in supporting people.