JHN Healthcare Ltd

This assessment considered the following five quality statements: Learning culture; Safe systems, pathways and transitions; Safeguarding; Involving people to manage risks; Safe and effective staffing.

At this inspection there was no evidence of closed cultures. There were enough suitably trained staff to meet people’s needs. Staff contacted other professionals appropriately to source additional health and social care support when required. Staff were able to raise issues and felt listened to and supported. Management and staff understood their responsibilities to safeguard people from abuse and harm. Whilst people told us they felt safe and well-supported, we identified gaps in some care records and risk assessments. This was discussed with the management team who took prompt action to ensure records were complete and provided staff with clear guidance on how to mitigate risks to individuals. There was evidence of learning from incidents and concerns, though clearer records were needed to demonstrate issues had been thoroughly investigated and followed-up. The management team undertook to update their records to ensure all activity was clearly recorded.

The rating for this key question remains Good.

This assessment considered the following three quality statements: Assessing needs; Supporting people to live healthier lives; Consent. We found areas of concern in relation to consent. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good.

Though the assessment of these areas indicated areas of concern since the last inspection, our rating for the key question remains good.

People told us staff sought their consent before providing care and support. However, we found a breach of the legal regulation in relation to consent. The service had failed to ensure people's rights were upheld within the principles of the Mental Capacity Act 2005.

People’s needs were assessed before they started to use the service. Whilst people told us staff knew them well and understood their specific needs, we found some information was missing from care plans. This was discussed with the management team who took prompt action to ensure records were complete and provided staff with clear guidance on how to support people. Staff supported people to manage their health and wellbeing and to enable them to live healthier lives.

This assessment considered the following four quality statements: Kindness, compassion and dignity; Treating people as individuals; Independence, choice and control; Responding to people’s immediate needs.

People and relatives spoke highly of the support they received and the relationships they had developed with staff. Staff understood people’s individual wishes and preferences and treated them with kindness, dignity and respect. Staff supported people to be as independent as they were able. Staff were alert to changes in people’s needs and took action when additional support was required. Whilst staff clearly knew people well, we identified gaps in some care records relating to people’s life history, personal abilities and things that were important to them. This was discussed with the management team who took prompt action to ensure records were complete.

The rating for this key question remains Good.

This assessment considered the following three quality statements: Person-centred care; Listening to and involving people; Equality in experience and outcome.

People received person-centred care from a consistent staff team who knew them well. Staff had completed training in equality and diversity and were alert to those who might experience inequality in experience or outcomes. Staff gave people opportunities to provide feedback about their care and experience of using the service. People knew how to raise a concern or complaint and felt confident they would be listened to. We identified that records of complaints did not demonstrate the extent of the actions taken. The management team undertook to review the recording system in place.

The rating for this key question remains Good.

This assessment considered the following four quality statements: Shared direction and culture; Freedom to speak up; Governance, management and sustainability; Learning, improvement and innovation. We found areas of concern in relation to good governance. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good.

Though the assessment of these areas indicated areas of concern since the last inspection, our rating for the key question remains good.

We identified improvements needed to systems and processes to ensure management had effective oversight and could identify areas requiring improvement. Clearer records were needed to demonstrate effective systems of governance and improvement. We identified a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The management team had a shared vision, strategy and culture which was communicated and shared by the staff team. Staff felt able and confident to speak up if they had any concerns. Processes encouraged feedback from people who used and were involved with the service. Staff felt supported by the senior team.