Jacob's Well

Updated 13 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection which took place on 8 and 9 October 2018. The inspection was announced and was carried out by one inspector.

We gave the service 48 hours’ notice of the inspection visit because the location provides a supported living service and we needed the registered manager to organise visits to the supported living locations and prepare people for our visit.

The service had submitted a provider information return (PIR), in January 2018. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help us plan the inspection.

Prior to the inspection we reviewed the information we held about the service. This included any notifications that we received. Notifications are reports of events the provider is required by law to inform us about. We contacted three representatives of the local authority who funded people supported by the service for their feedback and received no concerns.

During the inspection we spoke with the registered manager, the service managers of each supported living location and four other staff. We examined a sample of five care plans and other documents relating to people’s care. We looked at a sample of records to do with the operation of the service, including, training and supervision records and medicines recording. People were unable to verbally give us their views about the service. However, we did observe some of the care and interaction between them and support staff. Following the inspection, we emailed three family members and four staff to obtain their views about the service. We received feedback from three staff. The family members who contacted us did not raise any concerns about the service.

Updated 13 November 2018

The Slater Centre provides personal care to up to 12 people. The service provides care and support to people living in two shared house, (Heffernan House and Stella Maris House), in a supported living setting, so that they can live as independently as possible. At the time of inspection 11 people were receiving this service. People all had needs associated with learning disabilities or autism, some of whom may display behaviours which challenge the service. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living. This inspection looked at people’s personal care and support.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support an overall rating of good. In the “Effective” domain the service had improved to “Outstanding”. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were provided with highly effective care and support by a well-trained and qualified staff team who received regular ongoing support and development. People’s healthcare needs were very well met and the service advocated positively for them to receive the care and treatment they needed. People living with epilepsy received excellent support because staff had been trained and understood its individual impact on each person. Effective monitoring systems had been established to monitor seizures as safely as possible with the least disturbance.

People with complex dietary needs received excellent support. Staff were well informed and trained to provide specialist diets where necessary and did so effectively to minimise the impact of their illness on people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were supported to access a wide variety of activities and experiences in the community and had opportunities for supported work placements.

People’s rights, dignity and privacy were promoted by the staff in the way they provided support. Consent was obtained as far as possible prior to support being offered. Where necessary, appropriate professionals and other significant people had been involved in making ‘best interest’ decisions, if people were unable to make particular decisions themselves.

People were supported to maintain their safety as much as possible. Foreseeable risks were identified and assessed and appropriate action was taken to minimise them. Staff understood how to keep people safe and knew how to report any concerns. They were confident that management would take appropriate action should they report any issues.

People’s medicines were managed safely on their behalf by staff who had received training and had their medicines management competency assessed. The service supported a national initiative to reduce the unnecessary use of medicines for people with a learning disability. Behavioural support was offered using approved interventions for which staff had attended recognised training. The level of people’s recorded incidents had reduced significantly when compared to their history in previous placements. Staff recognised in the early stages, where people might require support to manage their behaviours. They were skilled at diversion and distraction techniques to refocus people onto things they enjoyed.

People’s needs were regularly reviewed involving relevant others, to ensure care plans remained up to date and relevant. Care plans and associated records were detailed and supported staff to deliver person-centred care.

The service had a robust recruitment system to ensure as far as possible, the suitability and skills of potential staff. Staffing levels were based on individual assessments of support needs within and outside their home.

The management team provided very effective governance of the service through a range of audits and monitoring systems and were also involved in day-to-day care. The service worked well with external care and health professionals.

The registered manager was actively involved in local initiatives to improve care, recruitment and retention. The values of the provider were widely known and familiar to staff. Staff were proud to work for the organisation. They felt very well supported and that the management team were accessible and approachable and very committed to providing positive care to people.

Further information is in the detailed findings below.