Frenchay Brain Injury Rehabilitation Centre

Our rating of this service stayed the same. We rated it as requires improvement because:

• The service had persistent challenges with recruitment and relied on agency staff to maintain the service, particularly out of hours. There were significant challenges and risks around this, which resulted in a deterioration of service for patients and their relatives during these times.
• Training completion rates for positive behaviour management, which was an important to maintain safety, were low and required immediate improvement.
• While staff managed incidents well, the categorisation and investigation of incidents was questionable, which meant learning and mitigation did not always receive adequate focus. This created a risk of future incidents that could potentially be avoided.
• While managers monitored the competence of substantive staff, there was no similar assurance for agency staff. Completion rates for positive behaviour management training did not meet safe standards.
• Patient records overall were of a good standard but there were inconsistencies such as missing Waterlow documentation and varying practice in managing pain scores.
• Fire safety records did not provide assurance of consistent standards of practice.

However

• Staff had training in most expected key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients and adhered to them when delivering care. Staff managed medicines well.
• Staff mostly provided good care and treatment, checked that patients ate and drank enough, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff mostly treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of people, took account of patients’ individual needs, and made it easy for people to give feedback. The service offered a referral to admission time that was better than comparable services in the region.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.