Archived: Frenchay Brain Injury Rehabilitation Centre

We rated Frenchay Brain Injury Rehabilitation Centre as good because:

The centre was set out in a way that patients with high dependency needs were closest to the nursing station. The area was clean and staff had ensured equipment was maintained appropriately. Two of the patient bedrooms were adapted to reduce ligatures and staff assessed patients risk and allocated rooms accordingly. The centre had nurses from a variety of specialties and had a large pool of bank staff to cover shifts if need be. Staff had completed physical health checks and all of the eight care records we reviewed contained up to date risk assessments. Staff were aware of what incidents to report and prior to inspection we saw evidence that they had acted in accordance with their duty of candour.

In the eight care records we reviewed, we found that staff had put in place holistic and patient centred care plans. These care plans had clear goals and were recovery focused. Patients had access to a variety of different therapeutic professions and had access to psychological therapies recommended by the Nation Institute for Health and Care Excellence. The centre had been involved in a national research project. Staff had access to external, specialist training and reported receiving regular supervision, and when we reviewed the records 90% of staff had received regular supervision and an appraisal. The use of the Mental Health Act was limited at Frenchay Brain Injury Rehabilitation Centre and there was no-one detained under the Act at the time of inspection. Staff held appropriate multidisciplinary meetings and also had strong links to local healthcare providers.

We observed staff treating patients with kindness and respect and all of the 17 comment cards we collected had a positive comment about the service. Staff were praised by patients and carers for being caring and supportive. Patients had access to advocacy and held patient forum meetings where they could share their concerns, although there had been gaps in the frequency of the meetings previously.

Due to the nature of the service and the funding by NHS England, there were clear discharge pathways and the hospital had an average bed occupancy of 100% in the 6 months prior to inspection. Patients had access to facilities such as a hydrotherapy pool to aid their recovery, as well as private spaces to meet their family. The building allowed access for people in wheelchairs and mobility aids and there was information available for patients on how to access advocacy or make complaints. Patients had access to meals that could meet their dietary requirements and staff facilitated access to spiritual support.

Staff at the centre were aware of the organisations vision and values. We found that there were appropriate governance systems in place to ensure that actions were taken following incidents and that the majority of shifts were covered. We found that staff had the chance to feed back to the service and suggest improvements and that the provider had set up a reward scheme to recognise staff achievements. Staff morale was high and staff we spoke with spoke highly of the service and their colleagues. The service had engaged in national research and also tracked their performance via a national clinical outcomes group they participated in.

However:

We also found that staff had stored equipment in the patients bedroom corridors due to the building work that was ongoing. This had not been risk assessed and could have formed a trip hazard. We informed the manager of this at the inspection and they had arranged the risks to be assessed and a plan to be put in place to manage them. We also found that the space where patients may have been restrained and de-escalated (should they become a danger to themselves or others) was visible from the corridor and this could have impacted on the patients privacy and dignity. We raised this with the manager at inspection and they arranged for a privacy screen to be put in place.