We carried out a review of the data available to us about Jellicoe Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Jellicoe Court, you can give feedback on this service.
Jellicoe Court is a supported living service providing personal care to both younger and older people who have a learning disability or autism.
People living at Jellicoe Court have their own self-contained flats. In addition, there is a shared lounge/kitchen on each floor, parking and a large communal garden. There is an on-site office and a sleep-in room for staff.
The service has been developed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This guidance ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service should receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service has been commissioned by the local authority to support people with disabilities to achieve independent living. It can accommodate up to 18 people, there were 14 people resident at the time of the inspection. This is larger than current best practice guidance. However, we have rated this service good because people were each provided with individualised and person-centred support to meet their needs.
People’s experience of using this service and what we found
Overall people and relatives told us they were happy with the service and the improvements made since the last inspection. One person said, “I love all the staff” and “I wouldn't change anything about my care.” Another said, “I like it here, just to say I do things myself. I'm very independent.”
The provider had assessed potential risks to people and supported them to stay safe whilst balancing their rights and freedoms. Processes were in place to protect people from the risk of acquiring an infection. Systems and processes protected people from the risk of abuse. People received their medicines safely from competent staff. There were enough skilled staff who had been recruited safely. Incidents were recorded and reviewed to identify any learning or further measures required for peoples’ safety.
Staff were supported both by the provider and stakeholders to ensure people’s care plans reflected current practice and guidance. Staff received appropriate training and support in their role. People were supported to access health services and to maintain a healthy lifestyle.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People received personalised care which was responsive to their needs. Staff ensured people had information in a format they could understand. People had opportunities for social activities and supported to maintain social relationships. Processes were in place to enable people to raise complaints and concerns and these were investigated and acted upon.
Staff at all levels had a clear understanding of their role and responsibilities. Processes were in place to monitor and improve the quality of the service provided. The service sought people’s views to identify areas for improvement. The service informed CQC of notifiable incidents. Overall, feedback from people, staff and other stakeholders showed positive improvements in the culture of the service.
Rating at last inspection (and update)
The last rating for this service was inadequate (published 8 April 2020). This service has been in Special Measures since January 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on actions we told the provider to take at the last inspection.
We previously carried out an announced comprehensive inspection of this service on 12 and 16 December 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Jellicoe Court on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Jellicoe Court is a supported living service providing personal care to both younger and older people who have a learning disability or autism. The service was supporting 15 people at the time of the inspection.
The service has not been fully developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This guidance ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service should receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service had been commissioned by the local authority to support people with disabilities to achieve independent living. It accommodated up to 18 people in separate flats. This is larger than current best practice guidance. People had tenancy agreements with the housing association which managed the building and people were supported by the provider. One person retained input from their previous provider as per their choice.
People’s experience of using this service and what we found
The service had been inadequately led. Commissioners had placed two people in the service, whose challenging and aggressive behaviours meant they were not suitable to be accommodated in this location. One person had since moved, but staff and people remained at risk of experiencing aggression from the remaining person and the safety of people and staff could not be assured, until this person moved to more suitable accommodation for their needs. Staff reported they did not feel fully safe working with this one person.
The provider although aware of issues within the service in relation to people’s safety and in particular staff’s safety, had failed to take robust action to protect them. There was a lack of robust systems to monitor and evaluate the quality of the service provided to people. There was a lack of evidence to demonstrate people’s views on the service had been sought. Records were incomplete, inadequate and not always there, for us to review. There was a lack of analysis of incidents and complaints to identify and address any trends.
The previous registered manager had recently left the service and had not led it well. They had not ensured their legal responsibilities were always met. They had not promoted an open and transparent culture. This meant commissioners and CQC had not been fully informed of all safety events at the service they should have been made aware of, for people and staff’s safety.
People’s risk assessments did not contain sufficient guidance for staff. There was a lack of written evidence to demonstrate identified risks to people and staff were all managed safely. People did not always receive their medicines safely, as robust records were not maintained to guide staff and ensure a complete record of people’s medicines administration.
People’s care records provided staff with insufficient information to provide truly person centred care. Although permanent staff had a good understanding of people’s care needs. This information was required in writing to ensure consistency across the staff team and to inform new staff. People were not always provided with information about their care in a format they could understand.
The provider had not ensured all relevant pre-employment checks had been fully completed on applicants to ensure their suitability to work with vulnerable people.
People were not always supported to have maximum choice and control of their lives although staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The provider had not always sought people’s consent for their package of care, although people were consulted by staff about decisions related to their day to day care. Where people lacked the capacity to consent to the provision of their care legal requirements had not been met.
The service did not consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons. People could not be totally free to make choices at all times due to the behaviours of one person, which impacted upon the safety of others. People’s records did not provide staff with sufficient information about people upon which to base the delivery of their care. Although people appeared to be involved by staff in a wide range of external activities. People’s records were not sufficiently complete to demonstrate best practice guidelines had been met.
People were going to be provided with accessible information about how to make a complaint. The provider was aware processes to capture complaints had not been sufficiently robust and planned to address this.
There were sufficient staff rostered to provide people’s care. Staff recruitment was on-going. Staff reported overall they felt supported in their role. Records did not demonstrate they had received the provider’s required levels of supervision and this was being addressed.
The service development implementation manager had evaluated the full extent of the issues within the service since they took day to day control in November and has prepared an action plan, which they plan to implement with the new manager. They have been fully open and honest during the inspection process about their findings.
People were treated with compassion, kindness, dignity and respect by staff. The staff demonstrated an interest in the welfare of the people they cared for and were knowledgeable about them. Staff involved people in day to day decisions about their care, including what they wanted do with their time and what they wanted to eat. Staff respected people’s dignity and privacy.
People were supported by staff to attend a diverse range of activities in the community and had opportunities for stimulation and development.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This service was registered with us on 29/03/19 and this is the first inspection.
Why we inspected
This was a planned comprehensive inspection.
Enforcement
We have identified breaches in relation to safe care and treatment, governance, consent, person centred care, notifications and requirements relating to workers.
Conditions have been placed upon the providers registration at this location.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.