Jubilee House is a residential care home that provides accommodation and personal care for up to 25 people, some living with dementia. There were 24 people living in the service when we inspected on 4 and 6 April 2017. This was an unannounced inspection.

A registered manager was in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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. They were supported by a deputy head of care who was also the registered manager of the provider’s other service Seckford Alms. This service provided personal care to people living in very sheltered flats. Both of the provider’s services were located within the Alms House building. The management team worked closely together and staff were experienced at working across both services. This supported continuity of care within the organisation and embedded the (provider’s) ‘Seckford Standards’ of involvement, compassion, dignity and respect in their practice.

At our last inspection 14 December 2014 we rated the service overall good and found responsive to be outstanding. At this inspection we found that the service had continued to develop and improve. People were at the heart of the service and received exceptional care that was personalised to them, taking account of their needs and wishes. People told us how staff went the extra mile to make sure that they were extremely satisfied with all aspects of their care.

Jubilee House was exceptionally well led. There was visible and effective leadership within the service. The service was effectively organised and well run with an open and transparent culture. The registered manager demonstrated a holistic approach and had clear oversight of how the service was meeting people’s physical, emotional and social needs. They were able to effectively demonstrate how their robust quality assurance systems had sustained continual development and improvement at the service. They were clear about their expectations relating to how the service should be provided and led by example.

Ensuring people received tailored care which enhanced their quality of life was integral to the running of the service. An enabling and supportive culture focused on meeting the individual needs of people had been established and was reflected in people’s care records. Staff respected people’s privacy and dignity and promoted their independence. They demonstrated an enhanced understanding about people’s choices, views and preferences and acted on what they said.

Staff were extremely compassionate, attentive and caring in their interactions with people. Staff understood the importance of obtaining consent when providing care. 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.

People and or their representatives, where appropriate, were actively involved in making decisions about their care arrangements. This led to people experiencing an excellent service which was distinctive to their individual needs.

People were encouraged to maintain relationships that mattered to them such as family, community and other social links. They were supported to pursue their hobbies and to participate in activities of their choice. This protected people from the risks of social isolation and loneliness.

The service provided outstanding end of life care. People experienced a comfortable, dignified death in line with their wishes

Staff enjoyed their jobs and understood their roles and responsibilities. They were passionate and committed to delivering a high standard of care. They were positive about the way the service was managed,

This inspection was unannounced and carried out on 4 December 2014.

Jubilee House is a care service for up to 19 older people who may be elderly, have a physical disability or be living with dementia. It does not provide nursing care. At the time of our inspection there were 19 people who used the service.

There was a registered manager in post. ‘A registered manager is a person who has registered with the Care Quality Commission 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 very positive about the service. They felt safe, were treated with kindness, compassion and respect by the staff. They were extremely satisfied with the care they received.

The service had innovative and creative ways of ensuring people could continue to enjoy their lives. People were encouraged and supported with their hobbies and interests and participated in a variety of personalised, meaningful activities, which included building links with pupils from the local schools and accessing the community.

People’s care was personalised to them and met their needs and aspirations. Staff listened to people and respected and acted on what they said. People were supported and encouraged to attend appointments with other healthcare professionals to maintain their health and well-being.

There was clear guidance for staff on how to meet people’s individual needs and aspirations, promote their independence and maintain their health and well-being. Where risks were identified to people’s health or well-being, action was taken to help minimise the risk as far as possible to keep people safe. Robust systems provided people with their medication in a safe manner.

There were sufficient numbers of staff with the knowledge and skills to meet people’s needs. Staff received training and on-going support to enable them to understand people’s diverse needs and work in a way that was safe and protected people’s rights. Staff ‘champions’ had more specialist knowledge in a particular areas which they promoted and made sure that best practice was developed and followed by all staff in the service. This helped deliver care that was right for each individual person.

The approach of managers and staff empowered people to make decisions about how they led their lives and wanted to be supported. They were able to voice their opinions and have their care needs provided for in the way they wanted. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests.

People had enough to eat and drink and were supported appropriately. People were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

People knew how to make a complaint and felt that any concerns were acted on promptly and appropriately.

Staff interacted with people compassionately and were interested in them and their lives. Where people were not always able to express their needs verbally staff were skilled at responding to people’s non-verbal requests promptly and had a detailed understanding of people’s individual care and support needs.

There was an open and transparent culture. Staff were empowered, highly motivated and morale was high. The registered manager led by example and had achieved two external care awards in recognition of their work in championing dignity in care and promoting best practice.

The management team planned, assessed and monitored the quality of care consistently. Systems were in place that encouraged feedback from people who used the service, relatives, and visiting professionals and this was used to make continual improvements to the service.

During our inspection we spoke with five people who used the service and one person’s relative. We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

One person we spoke with told us, “I couldn’t include praise high enough. It’s a wonderful commendable place.” Another person told us, “It’s a lovely place to be. It’s incredibly difficult to think of anything that could be improved.”

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. There were arrangements in place to deal with foreseeable emergencies.

We found that appropriate arrangements were in place in relation to the recording of medicines. Medicines were given to people appropriately and stored safely.

Appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place. We also found that people’s complaints were fully investigated and resolved, where possible, to their satisfaction.

People told us how well the staff looked after them. They always came as soon as the call bell was rung, and showed great concern and care. They were able to choose how they spent their time, and were helped to continue their hobbies and interests.