CQC report explained · a residential care home
What the CQC found at Juga Homes Ltd
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks to people's health and wellbeing were assessed, recorded and managed more clearly. Medicines, staffing, safeguarding, fire safety and infection control were generally managed safely.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- The home had improved its audits, care planning, incident records and staff communication. People, relatives, staff and other professionals were involved in reviewing and improving care.
What inspectors found, September 2021
Rated Good; inspectors found that earlier safety and management shortfalls had been improved, with a few minor issues addressed during the visit.
This was a follow-up inspection on 16 August 2021. Inspectors checked whether the home had acted on problems found previously. They reviewed one person's care plans, risk assessments and medicine records, and looked at infection control and quality checks. They also spoke with one person, three staff members and other professionals.
The home was rated Good for Safe and Well-led. Inspectors found that risks were now assessed and managed more clearly. Medicines, staffing, safeguarding, fire safety and infection control were generally managed safely. The home was clean, and accidents and incidents were recorded and reviewed more effectively.
The home had improved its quality checks, staff handovers and involvement of people and relatives. Inspectors found that earlier breaches relating to safe care and treatment and good governance had been put right. A few issues were identified during the visit, including missing records of staff COVID-19 test results and a lack of medicine competency assessments, but action was taken.
Improved risk management
Care plans covered a wider range of risks, including falls, mobility, eating and drinking, and skin care. Staff understood the risks affecting people and what action to take.
“The provider had improved the way risks to people's health and wellbeing were assessed, recorded and managed.” from the report
Clean and hygienic home
Inspectors found the home clean and hygienic. Staff followed cleaning schedules and infection control training was refreshed.
“The home was clean and hygienic when we visited, and this was confirmed by a relative who regularly visited.” from the report
Safe medicine systems
Medicine records checked by inspectors were completed correctly. Staff had relevant training, medicines were stored at the right temperature and there were clear instructions for medicines given when needed.
“People's medicines were well managed.” from the report
Better quality monitoring
The home had developed audits covering medicines, care plans, infection control, handovers, daily records and environmental safety. Accident and incident reviews also helped identify ongoing risks.
“The registered manager had developed the quality assurance audits which covered all aspects of the service including; medicines, daily reports, handovers, care plans, infection control and the safety of the environment.” from the report
COVID-19 test records
minorAt the time of the inspection, the home was not recording staff COVID-19 test results. The manager said recording had started after this was discussed.
“At the time of our inspection the service was not recording the results of the staff COVID-19 tests.” from the report
Medicine competency checks
needs fixingStaff had medicine training, but inspectors found that their practical competency had not been assessed. The manager then introduced competency assessments to be reviewed at least yearly.
“However, we found staff medicine administration competency had not been assessed.” from the report
Autism training and notification
needs fixingAutism training was not previously part of the ongoing training plan, and the home had not submitted a required notification when it began supporting people with different needs. The manager arranged ongoing training and submitted the notification.
“However, we identified that Autism training was not part of the provider's ongoing training plan.” from the report
- 01How are medicine administration competency assessments completed and reviewed for every staff member?
- 02How do you record and check staff COVID-19 test results now?
- 03What autism awareness training has each staff member completed, and when will it be refreshed?
- 04How are risks and changes in people's care plans discussed during staff handovers?
- 05How are relatives involved in reviewing care plans and acting on their feedback?
This was a follow-up inspection focused on Safe and Well-led; the report only gives ratings for those two questions and inspectors reviewed one person's care and medicine records. This explanation was written from the published report of 18 September 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2020
Inspected but not rated; inspectors found serious gaps in risk records and governance, although people felt safe and supported.
This was a targeted inspection on 02 July 2020. It followed concerns about how the home managed risks linked to people's mental health and wellbeing. The inspector spoke with people, staff, the manager, a family member and a health and social care professional, and reviewed care records and other documents.
Inspectors found that care plans and risk assessments did not always explain risks clearly or tell staff what to do. Records of welfare checks, changes in support and serious incidents were also incomplete. This meant staff might not have had the information needed to keep people safe.
The home had safeguarding procedures, regular health and social care links, staff induction and supervision. People said they felt safe and supported. However, inspectors found breaches of Regulation 12 on safe care and treatment and Regulation 17 on good governance.
The service was inspected but not rated. The previous overall rating was Good, but this targeted inspection did not assess all parts of the service or change the previous rating. A comprehensive inspection was planned to assess all key questions.
People felt safe
People told inspectors they felt safe. Staff understood safeguarding procedures and knew how to report concerns.
“People told us they felt safe.” from the report
Staff support
New staff received a thorough induction and staff reported regular supervision and support from the manager.
“New staff had a comprehensive induction and probation period which included the completion of the care certificate to ensure they were competent to deliver care and support.” from the report
Healthcare links
The home worked with health and social care professionals, including mental health professionals, to monitor people's health and medicines.
“The service also ensured they liaised with mental health professionals such as care coordinators and psychiatrists to monitor people's mental health and ensure their medicines were reviewed when necessary.” from the report
Support for personal goals
People said they were supported to work towards their goals and aspirations, and staff described helping people make progress.
“People told us they felt supported to work towards achieving their goals and aspirations.” from the report
Unclear risk plans
seriousCare plans and risk assessments did not always set out the level of risk or the actions staff needed to take. This included risks linked to self-harm, self-neglect, medication, cooking and falls.
“People's care plans and risk assessments were not always clear about the level of risk or what actions were required to mitigate risks to their safety.” from the report
Incomplete incident records
seriousSerious incidents, including incidents that led to the police being called, were not always recorded as required.
“Staff did not always make appropriate records of serious incidents that occurred within the service as set out in the provider's accidents and incident policy.” from the report
Limited training
needs fixingStaff had not received specific training on supporting people with behaviours that challenge. Inspectors recommended that the home review its training.
“The training was refreshed annually however, we identified that staff had not had specific training in supporting people with behaviours that challenge.” from the report
Weak quality checks
seriousThe home's own monitoring systems had not identified or corrected the problems in risk assessments, care plans and incident records.
“The registered manager understood their role to manage safe care and treatment. However, the issues we identified with the risk assessments, care plans and incident reports had also not been identified and addressed through their own quality assurance processes.” from the report
- 01How have you updated each person's care plan and risk assessment when their mental health or support needs change?
- 02How do you record and check welfare checks for people at risk of self-harm?
- 03How do you record serious incidents, including incidents involving behaviour that challenges or police attendance?
- 04What training have staff received on supporting people with behaviours that challenge?
- 05What action have you taken in response to the Regulation 12 and Regulation 17 breaches, and can we see the action plan or evidence of improvements?
This was a targeted inspection of specific concerns about assessing and managing risks linked to people's health and wellbeing; all key questions were not assessed and the previous ratings were not changed. This explanation was written from the published report of 8 August 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Juga Homes Ltd
2 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2021Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2020Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
- August 2018GoodSafe: GoodWell-led: Good
- September 2017Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- January 2016
Registered with the Care Quality Commission on 21 January 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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