Jacobs Neurological Centre

Updated 22 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by two inspectors.

Service and service type

Jacob’s Neurological Centre is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Jacobs Neurological Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for two months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before inspection

Before our inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us. We had not requested a provider information return (PIR) to be submitted to us at this time. This is information that the provider is required to send to us, which gives us some key information about the service and tells us what the service does well and any improvements they plan to make.

During the inspection

We spoke with 12 members of staff, including nurses, health care assistants and the management team. We spoke with three people who used the service and received feedback from four relatives. We received feedback from external professionals including representatives of the Clinical Commissioning Group and the local authority.

We reviewed care records relating to five people who used the service and other documents central to people's health and well-being. These included staff training records, medicine records and quality audits. We checked how essential equipment was used, stored and managed, staff medicine administration practice, and how clinical risks were assessed and mitigated.

Updated 22 December 2022

About the service

Jacobs Neurological Centre is a ‘care home’ providing the regulated activity of accommodation and nursing or personal care, for up to 60 people, aged 18 years or older. Support was provided to people with complex long-term neurological conditions, brain or spinal injuries.

Jacobs Neurological Centre provides nursing care, personal care, medical treatment and diagnostic procedures in a purpose-built environment over two floors. Staff support people’s recovery wherever possible and specialise in slow stream rehabilitation. Some people had lived there for many years, and others were more recent admissions working towards returning to their own homes. There were 56 people accommodated at the home at the time of this inspection.

People’s experience of using this service and what we found

The provider had a system to ensure lessons were learned from incidents, accidents, complaints and external professional feedback. People received their medication safely, and in line with current best practice guidance. Risks to people’s health and welfare were identified, and actions were taken to manage risks. Risk assessments covered all aspects of people’s health and welfare including medical conditions and preferences for engagement.

Staff knew how to safeguard people from avoidable harm and were knowledgeable about the potential risks and signs of abuse. People felt safe at Jacobs Neurological Centre. Enough staff were available to support the needs of people using the service. Some staff were agency temporary staff; however, a successful recruitment campaign meant the service would be fully staffed once recruitment checks had been completed.

The provider had systems to help ensure people were protected from the risk of infection. People enjoyed having unrestricted visits from friends and family.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

A different provider was running the service, and a new manager was in post since the previous inspection of this service. The new management and staff team were proud of the service they delivered, and understood the importance of their role, and the need to operate effective quality monitoring systems. The provider had robust systems for monitoring complaints, and the manager had a clear understanding about the duty of candour.

Staff said the management team were approachable and supportive, and all relatives providing feedback confirmed they were aware of the provider and management changes. Some relatives declined to share opinions yet as it was, “early days”.

There was a clear management structure and the provider operated an overarching governance system to monitor how each department fulfilled their role. Actions were taken to address any shortfalls identified. The provider kept incidents and events under review and outcomes were shared with the staff team to encourage ongoing learning. The management team had developed a service improvement plan showing actions needed to address the shortfalls and in what timeframe. The service worked closely with a wide range of external professionals to achieve good outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service under the previous provider was good, published on 16 June 2018.

Why we inspected

We received concerns in relation to the management of medicines, staffing and people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained Good based on the findings of this inspection. We found no evidence during this inspection that people were at risk of harm from the concerns raised. Please see the Safe and Well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Jacobs Neurological Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.