Jacobs Neurological Centre

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People and their relatives felt informed about all aspects of care, including safety. One person told us, “I love it here. I feel very safe with the staff.” One relative told us, “We find it (the service) excellent, and we think [relative] is very safe.”

Staff told us they knew how to report any incidents, accidents or untoward events. They confirmed that they were made aware of any changes to practice, or learning, from events that occurred.

The provider had made changes to their systems and processes to enable robust oversight. This was embedding into everyday practice. Learning was seen to be shared with people, staff and stakeholders where needed.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People, and their relatives, were involved in admission to the service as much as they were able to and wanted to be. One relative told us, “We were involved throughout the referral process and helped put the care and support plan together.”

Multi-disciplinary meetings were regularly held. We saw those discussions, and the subsequent plans of care, were focused on people. Clear information was available to all those involved in the delivery of people’s care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their relatives told us they felt safe. One person told us, “Staff are respectful, and I think they treat me really well. That makes me feel safe with them.” A relative told us, “[Relative] really likes the staff he likes. We don’t have concerns about abuse or neglect and when raising concerns they are acted upon.”

Staff knew how to recognise, and respond to, signs of potential abuse. Staff had undertaken training and information about safeguarding people was displayed.

The provider had a system in place to report any safeguarding concerns. There was a designated member of senior staff who held the position of ‘safeguarding lead’ and they, along with the provider, maintained an accurate record of any referrals made to the local authority, along with any outcome once received.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and their relatives told us they felt staff knew and understood potential risks to health, safety and wellbeing. One person told us, “They (staff) understand all the risks. They know that they can’t [explained a personal risk]. They know and understand that.” A relative told us, “I feel the staff working with [relative] understand about the risks involved in [their care]. Some of them are excellent.”

Risk assessments were detailed and personalised. Staff confirmed they were aware of the assessments in place, the actions they should take whilst working with people and how to escalate any concerns they might have. We observed staff working in accordance with assessed risks.

Checks were completed by senior staff and the nurses on duty to ensure that tasks required were completed and guidance was being adhered to.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People and their relatives expressed feelings of being safe and comfortable at the service. One relative told us, “I think the environment meets [relative’s] needs.”

We observed the environment to be clear and spacious, with equipment in place and readily available. We noted that some large pieces of furniture were not fully secured and could present a risk to people. Maintenance personnel attended to this immediately when brought to their attention.

The provider had a system in place to ensure that equipment and facilities were routinely serviced and maintained. Audits and checks on the environment were completed, with action taken when identified as needed.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and their relatives told us they felt that staffing levels were sufficient. One person told us, “I think there is enough staff, they are all lovely. Only sometimes do they seem a bit rushed.” A relative told us, “The staff are well trained and know what to do. The staff do everything for [relative] and there always seems to be staff in and out of [their] room.”

We observed staff were visible and prompt when people needed or requested supported. Regular checks were completed on people and staff were deployed effectively across the building. Where 1:1 support was required for people, staff were present at all times and were seen to be attentive to the individual they were providing care to.

Systems were in place to ensure staff received the training, support and supervision needed for their roles. Records we reviewed confirmed this.

Staff recruitment was safe and all essential pre-employment checks were completed prior to a staff member starting work.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and their relatives raised no concerns or issues when asked about hygiene or infection prevention and control (IPC). One relative told us, “The environment is kept clean. I have seen staff wearing PPE (personal protective equipment) when involved with personal care and [relative] has good personal hygiene”.

The environment was clean. We saw housekeeping staff completed a wide variety of tasks in their daily routine.

IPC audits were completed, with an up-to-date policy and guidance in place for all staff.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

One relative told us, “I am aware of the medication that [relative] is taking and am informed of any issues. I believe [they are] receiving medication in a timely manner.”

We observed medicines being administered in a positive, personalised way.

We checked quantities of medicines against records held. During our checks we found that staff had signed administration records in advance of the medicines round which was due to be completed. This is not in line with good practice. We raised this with the provider who immediately took action to address this with the staff members concerned. We were assured by the action taken and the measures implemented, which included a ‘lessons learnt’ activity shared with all staff.