Archived: Hothfield Manor Acquired Brain Injury Centre

Updated 25 February 2020

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 registered 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 Care Act 2014.

Inspection team

The inspection was completed by an inspector and a specialist professional advisor. The specialist professional advisor was a registered nurse who specialised in the provision of nursing and rehabilitation services for people who have acquired a brain injury through trauma or stroke.

Service and service type

Hothfield Manor Acquired Brain Injury Centre is a care home with nursing and a rehabilitation service. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means they and the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was a clinical psychologist.

Notice of inspection

The first day of the inspection was unannounced and the second day was announced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used information the registered provider sent us in the provider information return. This is information registered providers are required to send us with key information about their service, what the service does well and improvements they plan to make.

We sought feedback from the local authority and health and social care professionals who work with the service. Three social care professionals gave us feedback. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with four people staying in the NRU, six people living in The Manor and two relatives

We spoke with four rehabilitation assistants, the lead nurse, care lead and head of support services who oversaw the management of the building. We also spoke with the activities coordinator, an occupational therapist, physiotherapist and the speech and language therapist. We met with the registered manager who was a clinical psychologist and who provided psychological treatments to people staying in the NRU.

We reviewed documents and records that described how rehabilitation and care services had been planned, delivered and evaluated for eight people.

We examined documents and records relating to how the service was run. This included health and safety, the management of medicines and staff training and recruitment. We also looked at documents relating to learning lessons when things had gone wrong, obtaining consent and the management of complaints.

We reviewed the systems and processes used to assess, monitor and evaluate the service.

Updated 25 February 2020

About the service

Hothfield Manor Acquired Brain Injury Centre is registered as a care home with nursing and as a rehabilitation service for 32 older people, younger adults and people with physical adaptive needs.

The service was in two parts. People staying in the Neurological Rehabilitation Unit (NRU) were usually admitted directly from hospital after treatment for traumatic head injuries or strokes. They generally stayed for 12 weeks when they worked intensively on developing their independence with support from nurses, physiotherapists, occupational therapists, psychologists and technicians. There was also a speech and language therapist. The NRU was run by the lead nurse.

People living in The Manor stayed for longer and some had made it their home. Others continued to progress their recovery from brain injuries with the intention of moving on. The Manor was run by the care lead.

There was a team of rehabilitation assistants who worked in both parts of the service. They provided people with practical assistance including washing and dressing and promoting continence.

In this inspection report when applicable we refer collectively to nurses, rehabilitation professionals, rehabilitation assistants and technicians as being, ‘staff’.

The two parts of the service were self-contained each having lounges, shared use bathrooms and toilets and bedrooms.

There were 28 people living in the service at the time of our inspection visit.

People's experience of using the service and what we found

People and their relatives were positive about the service. A person staying in the NRU said, “I think the service is very good. It’s a shock to need to be here but I’m glad I’m getting the help I need to get better.” In a thank-you card to the service a person who had stayed in the NRU said, A really big thank-you to everyone for your patience, encouragement, nursing skills helping in so many ways, it was really appreciated. Without my time at Hothfield Manor I would not be in such good health and strength as I am today (and be able to leave early also)!

People had not always been supported to use medicines safely. However, robust steps had been taken to reduce the risk of further mistakes being made. We have made a recommendation about the safe management of medicines.

People were safeguarded from the risk of abuse. People received safe care, treatment and rehabilitation from nurses, rehabilitation professionals and rehabilitation assistants who had the knowledge and skills they needed.

There were enough staff on duty and safe recruitment practices were in place. Accidents and near misses had been analysed so lessons could be learned to help avoid preventable accidents. Hygiene was promoted to prevent and control infection and people had been helped to quickly receive medical attention when necessary.

People were supported to have maximum choice and control of their lives and care 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 accommodation was designed, adapted and maintained to meet people’s needs and expectations.

Equality and diversity were promoted. People were treated with kindness and compassion and their right to privacy was respected.

People were consulted about their rehabilitation and care. They had been given information in a user-friendly way and supported to avoid the risk of social isolation. There were robust arrangements to resolve and learn from complaints. The service did not provide end of life care.

Quality checks had been completed and people had been consulted about the development of the service. Good team work was encouraged and joint working was promoted.

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

Rating at last inspection

The last rating for this service was Good (published 8 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.