Sharon Howson, Assistant Manager at Mary and Joseph House, explains how the Manchester care home achieved the rating of Outstanding in all five areas — Safe, Caring, Responsive, Effective and Well-led — in their recent Care Quality Commission (CQC) inspection.
Mary and Joseph House is leading the way in residential care. The care home in Ancoats, Manchester is part of The Joseph Cox Charity and has been awarded an overall Outstanding rating by the CQC in a recent report, making it one of only four in the UK — and the only care home in Manchester — to hold the status in all five areas of inspection.
Mary and Joseph House has become a role model in its approach to “partnership care”, working with residents to facilitate their rehabilitation through meaningful activities and tailored care programmes to suit the needs of the individual.
Home to 41 gentlemen aged between 40 and 80 years old, Mary and Joseph House is part of The Joseph Cox Charity which was founded in 1963 as a result of concerns raised for the welfare of homeless men in Manchester. Now chaired by Joseph’s son, John Cox, the charity opened Mary and Joseph House in 1993 to address the increasing demand for residential facilities equipped to deal with alcohol-related brain damage (ARBD) or Korsakoff’s Syndrome. A voluntary Management Committee is responsible to the trustees of the charity and oversees the continued work.
What makes Mary and Joseph House Outstanding?
We have values-based recruitment policies and our residents are involved in selecting the staff that will support them by being part of the interview process. With new staff, we follow a robust induction model that gives staff the skills and confidence to carry out their role and responsibilities effectively so that people have their needs met and experience a good quality of life. All our existing staff have completed the Care Certificate including new starters.
Our staff are all highly trained and have a high level of skills, knowledge and experience, and we maintain a high ratio of staff to residents to keep people safe and meet their needs.
Residents and staff are actively encouraged to raise concerns, and we hold monthly resident meetings, chaired by the residents and minuted. Dignity in care, concerns and complaints are all featured on the agenda. Regular feedback is requested from staff and residents through questionnaires as part of our quality assurance programme.
The management at Mary and Joseph House encourages staff to become champions and currently we have staff champions in Dignity, Dementia, Food and Nutrition, and Infection Control. All the champions are knowledgeable and share information about their area of expertise with residents and staff.
We hold twice-weekly best practice meetings with all staff to encourage creative thinking in relation to people’s safety. Handovers are carried out twice per day and we use innovative technology to manage individual risks, such as epilepsy bed sensors, personal alarms and nurse calls.
We carry out regular quality assurance audits and also infection control, fire, health and safety, buildings, COSHH, and information governance risk assessments. We have a contingency plan in place to address unexpected hazards.
We regularly collect feedback about the effectiveness of the care, treatment and support provided to our residents. The following is a quote from a friends and family questionnaire:
Perfection personified. I have worked for the NHS for the past 28 years and I have never had the pleasure of visiting such an Outstanding residential home. (My husband’s) social worker from the hospital was reduced to tears by the warmth, care and compassion shown by the staff to all residents. I truly believe that Mary & Joseph House should be the benchmark that all care homes should aspire to.
We continuously sustain outstanding practice through regular learning and development opportunities. The home has received recognised accreditation since 2009 as an “Investor in People” organisation. Staff have regular supervision with their manager to discuss their role as well as an annual appraisal. At the twice-weekly best practice meetings, staff share positive outcomes and reflective practice.
Mary and Joseph House has a homely welcoming environment where the décor and design are of a high standard. Residents experience outstanding care and support that means they have a meaningful life and promotes their wellbeing. Links with health services are excellent, residents feel comfortable discussing their health needs and are provided with understandable information ensuring they can make informed choices and have access to healthcare that is of a high standard.
We are a community and there are areas where residents can meet and socialise safely, reducing isolation and increasing residents’ sense of being part of the community. We provide innovative technology to enhance the lives of the residents; there is free Wi-Fi throughout the home, residents can be supported individually or in a small group to use a tablet promoting freedom, independence and wellbeing. If residents have Wi-Fi access in their rooms they can read the news, find out what is happening in their local community and across the world. Skype and FaceTime enable residents to keep in contact with family and friends at minimal cost.
Residents are cared for by long-term competent staff that know them well and have a good understanding of their physical and mental health. Staff are committed at all times to treating residents with kindness, showing empathy and compassion, dignity and respect by responding to residents needs in a caring and compassionate way.
We have a high ratio of staff to residents which allows staff to spend time building trusting relationships. Residents, families, health professionals and other visitors to the home consistently provide positive comments about the caring attitude of the staff.
Residents are encouraged to work in partnership with staff to undertake daily household tasks such as cleaning their rooms or preparing the dining room. Residents’ opinions are sought about the décor of the house and garden providing them with a sense of self-worth and reinforcing that their opinions are valued.
Care plan reviews are carried out every month with our residents, to look at what is working and what doesn’t work, and what might need to change. Every resident has a one-page profile at the front of their care plan as a starting point to gathering person-centred information; helping care and support workers to get to know the person they are supporting as an individual — not just a list of needs or conditions. We include:
“What is important to them” — embracing the important people, places, possessions, rituals, routines, faith culture, interests, hobbies, work, etc which makes the person who they are
“How they want to be supported” — what kind of support is really helpful for the person; what they want and need
“What others like and admire about them”.
As well as having highly trained and motivated staff that seek to make recovery a reality, the residents at Mary and Joseph House are also involved themselves in taking part in training workshops such as first aid, infection control, fire safety, and equality and diversity.
At Mary and Joseph House care is responsive to residents’ needs; residents are asked about what is important to them and receive care and support in accordance with their preferences. To quote from a visiting healthcare professional’s questionnaire: “The quality of care residents receive is outstanding.”
Residents are supported by well-trained competent staff who make sure that the views of the resident are known, respected and acted on. Changes in need are responded to promptly and communicated to all staff, allowing residents to have as much choice, control and independence as possible. Residents who suffer mental health distress are involved in creating a wellness recovery action plan (WRAP) so that they can, with support, identify their own strengths, understand their own triggers to illness and be active participants in their own good mental health. The person, not the organisation, leads and controls the process.
Residents who are disabled receive the reasonable adjustments that equalities legislation says they should receive. We also use assistive technology: residents who suffer from seizures have a “seizure pad” on their bed that alerts staff immediately through a phone. Staff can then stay with the resident and ensure their safety until the seizure is over, this can often prevent the need for an ambulance to be called.
Mary and Joseph House has excellent links within the local community which allows residents access to education as well as social and leisure activities.
Transition between services is properly planned and residents are supported through the process. We have a robust discharge policy in place to ensure that the transition is as smooth as possible for residents, providing them with key information and support. We have had excellent success with residents moving on to more independent living and some residents have even returned to the home as volunteers and paid employees.
Mary and Joseph House has a robust quality assurance and service improvement system in place helping to drive continuous improvement. All staff are involved in creating our business plan, consistently putting our vision and values into practice, and focusing on safety and the other key issues. We carry out regular questionnaires with residents, families, staff and visitors. We actively seek out and act on the views of staff, listening to what they tell us. We have recently looked at staff wellbeing with regard to shift patterns on the rota while ensuring the rota meets the needs of our residents and business.
The management team also promote best practice at twice-weekly meetings with all staff. The home manager attends registered managers’ network meetings which are supported by a representative from Skills for Care and are a source of rich information. We keep ourselves up to date with new research and sector specific guidance around best practice in leadership by using information from Croner-i Care Home Management and Skills for Care.
At Mary and Joseph House, the registered manager and supportive management team have the required experience, qualifications and skills, including knowledge of the regulations, inspiring staff to provide a quality service to our residents and meet our legal obligations. The management team lead by example and promote an open and transparent culture, where staff have the confidence to challenge poor practice and raise concerns, knowing they will be fully supported and all concerns will be investigated fully.
There is a strong emphasis on continually striving to improve. The management team encourages the staff to develop and to drive improvement; care workers and housekeeping staff have been empowered to look for risks, and find innovative and creative ways to work with residents around positive risk taking. All of our staff have signed up to make the Social Care Commitment.
Our vision and values are person-centred. Managers help staff to understand why values matter and how they fit into their day-to-day work, encouraging them to take responsibility for upholding positive workplace values. Staff understand their roles and are innovative and motivated. It is imperative that our staff experience a positive workplace culture because it gives all our staff an identity, a sense of belonging, an ambition to do their very best and to work with others to make a difference to the lives of the people we support. Our staff do really feel valued and proud of the organisation and the people they work with.
The report from the CQC reflects the hard work and commitment of the whole team at Mary and Joseph House. Here is a quote from Debbie Westhead, Deputy Chief Inspector of Adult Social Care in the North:
“From the moment we arrived we found an open atmosphere, where people living there were free to move around as they wished, access the internet on provided equipment and contact friends and relatives. The home was well designed to facilitate this way of living.
“The attitude of the registered manager and staff was truly inspiring. They all strived for excellence, and continually reflected on how they could make the service better.
“We saw that people were treated as individuals, with care plans tailored individually by staff that knew them well and understood how to support them to maximise their potential and achieve their goals.
“The whole team should be very proud of the service they are providing.”
Last reviewed 5 June 2017