CQC report explained · a residential care home
What the CQC found at Julians House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors looked at safeguarding, medication, travel risks and infection prevention. They found changes had been made after medication errors and found infection control arrangements reassuring, but noted blurred personal boundaries between staff and residents.
- Effective?
- Good
- This key question was not assessed during this targeted inspection.
- Caring?
- Good
- This key question was not assessed during this targeted inspection.
- Responsive?
- Good
- This key question was not assessed during this targeted inspection.
- Well-led?
- Good
- This key question was not assessed during this targeted inspection.
What inspectors found, March 2021
Inspected but not rated; the previous Good rating remained, with safety concerns checked and infection controls found reassuring.
This was an unannounced targeted inspection on 09 March 2021. Inspectors looked at specific concerns about safeguarding, medication, travel risks and infection prevention. They spoke with three staff members and checked care, training, medication and infection control records.
The home had warm relationships with residents, and staff understood their needs. Inspectors found that changes had been made after two medication errors. An updated risk assessment also gave staff clearer instructions about travel during COVID-19 restrictions.
Inspectors found the home was managing infection risks, including PPE, testing, social distancing and cleaning. They did identify concerns about blurred personal boundaries between staff and residents, which managers addressed with the staff team.
The service was inspected but not rated at this visit. Its previous overall rating of Good remained. This inspection did not assess every part of the five key questions.
Warm relationships
Inspectors found that residents and staff had warm, relaxed relationships. Staff understood residents' different needs and residents trusted them to keep them safe.
“People and staff enjoyed warm and relaxed relationships.” from the report
Contact with relatives
Staff supported residents to keep in touch with relatives during COVID-19 restrictions, including helping one person celebrate a birthday with extended family digitally.
“Staff supported people to maintain contact with relatives.” from the report
Infection control
Inspectors were assured that the home was using PPE safely, supporting testing and following shielding and social distancing rules.
“We were assured that the provider was using PPE effectively and safely.” from the report
Clearer travel planning
After the inspection, the interim manager shared an updated risk assessment explaining how staff should manage travel and people's expectations when venues were closed.
“The interim manager shared an updated risk assessment that set out clear instructions for staff” from the report
Professional boundaries
needs fixingInspectors had received concerns about staff behaviour and found that personal boundaries had become blurred. Managers arranged a staff meeting to remind the team about appropriate behaviour and workplace values.
“The management team acknowledged that there had been a blurring of personal boundaries.” from the report
Previous medication errors
needs fixingThe home had reported two medication errors before the inspection. Inspectors found that changes had been made to medication administration to reduce the risk of further errors.
“Prior to this inspection visit we had been advised of two medication errors.” from the report
- 01What specific changes were made after the two medication errors, and how do you check that they are working?
- 02What rules now apply to staff behaviour and personal boundaries in residents' rooms?
- 03How do you assess and manage risks when residents travel in the minibus?
- 04How do you support residents when COVID-19 restrictions or closed venues limit their activities?
- 05Who is currently responsible for the home day to day, given that no manager is registered with CQC?
This was a targeted inspection of specific concerns under Safe, including infection prevention and control; the previous ratings were not reassessed and the other key questions were not inspected. This explanation was written from the published report of 20 March 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, November 2017
Julians House was rated Good; inspectors found safe, caring and personalised support, with some redecoration and refurbishment scheduled.
This was an unannounced inspection on 3 October 2017. One inspector reviewed care plans, risk assessments, medicine records and other records. They spoke with one person, staff, managers, a visiting health professional and relatives.
The home supported five people with learning disabilities and autism, although it could accommodate up to seven. Inspectors found enough staff, safe medicines practice, suitable training and support, and care plans that reflected people's needs. Staff understood how people communicated, including when they could not use speech.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. At the previous inspection in January 2017, the home had not met all regulations because some identified issues were not resolved. Inspectors found the necessary improvements had since been made.
Enough staff
Inspectors found enough staff to meet people's needs, including when people needed two or three staff members in the community.
“There were enough staff to meet people`s needs effectively.” from the report
Safe medicines
Medicines were stored, administered and recorded safely. Records showed people received medicines when they needed them.
“Medicines were stored securely and at the correct temperature.” from the report
Personalised communication
Staff understood people's body language, facial expressions, likes and dislikes. This helped them provide personalised support to people who could not communicate verbally.
“Staff were knowledgeable and they could describe to us how people communicated with their body language or facial expressions” from the report
People's views
People could raise concerns and suggest improvements through regular meetings with their keyworkers.
“People had the opportunity to raise concerns or ideas for improvement at regular `Your Voice` meetings with their keyworkers.” from the report
Improved oversight
The home had improved its governance since the previous inspection. Managers and the provider's quality team followed up issues through a service improvement plan.
“We found that when issues were identified these were added to a service improvement plan which was closely monitored and checked by the managers and the provider” from the report
Some premises work was pending
minorAn audit found that the home needed redecoration and refurbishment in some areas. The work had been approved and scheduled, but the report does not confirm that it was finished by the inspection.
“an audit identified that the home needed re-decoration and some areas were in need of re-furbishing.” from the report
- 01Has the redecoration and refurbishment identified in the inspection report now been completed?
- 02How do you make sure care plans and risk assessments are updated promptly when someone's needs change?
- 03How do you support people who become anxious when unfamiliar visitors or workers are in the home?
- 04How are people's communication methods, including body language, facial expressions or Makaton, recorded and shared with new staff?
- 05How do people and families give feedback, and what changes have been made in response to that feedback?
This was an unannounced inspection covering all five areas and the overall rating, but inspectors could observe staff supporting people only briefly because some people became anxious around visiting strangers. This explanation was written from the published report of 4 November 2017 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 Julians House
3 rated inspections over 2 years: the service has held its Good rating throughout.
- March 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- November 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Registered with the Care Quality Commission on 18 December 2013.
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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