Archived: Heathside Neurodisability Unit

We found the following examples of good practice.

The risks associated with Covid-19 were considered and plans were in place to mitigate these risks. There was a clear system in place to ensure everyone adhered to best practice guidelines when entering the service.

Visits from family members had been assessed and adapted as risk factors changed. At the time of the inspection visits were taking place in the garden area to reduce the amount of people entering the service.

The provider had systems in place to ensure stocks of personal protective equipment (PPE) were maintained. All staff received training in infection control and the correct use of PPE. There was signage throughout the service to remind residents, staff and visitors of best practice guidelines.

People were routinely tested for an active coronavirus infection by the hospital and from the community before they were admitted to the service. People also completed a period of self-isolation when they entered the service to further reduce the risk of bringing in an infection.

The service was taking part in regular ‘whole service’ testing in line with current government guidance to protect all residents and staff. The testing schedule was reviewed in line with advice from local health protection teams.

Plans for isolation and cohorting of exposed and unexposed people had been used effectively when people using the service received a positive coronavirus test result.

The service has a designated lead for cleaning and infection control within the service. Cleaning schedules had increased to reduce the risk of infections being spread on high touch areas such as door handles and light switches. The service was following current government guidance and was using viricidal cleaning products to ensure cleaned areas were completely sanitised.

Further information is in the detailed findings below.

We found the following examples of good practice.

There was a clear system in place to ensure all visitors adhered to best practice guidelines when entering the service.

Measures such as isolation and cohorting of exposed and unexposed people have been risk assessed and there were workable plans in place.

People have been tested for COVID-19 by the hospital and from the community before they were admitted to the service.

Clinically trained staff delivered infection control training and staff knowledge and understanding was continually checked and refreshed.

The service has a designated lead for cleaning and infection control within the service. Cleaning schedules had increased to reduce the risk of infections being spread on high touch areas such as door handles and light switches.

The provider had assessed the risks to staff including those associated with ethnicity, age, health conditions. The provider had also considered the risks of staff travelling on public transport and had made adjustments to help mitigate these risks.

Further information is in the detailed findings below.

Heathside Neurodisability Unit is a care home with nursing, providing support, accommodation and rehabilitation for up to 18 people. The home specialises in providing rehabilitation for people with a brain injury and/or progressive neurological conditions. At the time of the inspection 18 people were using the service.

People’s experience of using this service and what we found

People were protected from the risk of abuse or harm. Medicines were managed safely. There were systems in place to asses risks and strategies were in place to mitigate these.

People’s needs were assessed, and care plans put in place to meet these. The service employed a range of multi-disciplinary professionals who worked together to plan and deliver rehabilitation programmes.

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.

People were positive about the kind and compassionate attitude of the staff team. Staff promoted people’s dignity and independence. People were consulted about every aspect of their care and support.

People knew how to complain if they were unhappy about their care and support. Staff had a good understanding of people’s needs and preferences. People had access to advocacy services to enable them to discuss and feedback about the care and support they received.

People who used the service were positive about the staff and the management and felt the service supported them to progress through their rehabilitation. There were a range of systems and opportunities in place to get feedback and suggestions for improvement.

Rating at last inspection

The last rating for this service was requires good (published 22 April 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 re-inspection programme. If we receive any concerning information we may inspect sooner.

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

At our previous inspection on 3 June 2016 we found the service did not meet all the regulations we inspected relating to staffing. We undertook a comprehensive inspection on 14 and 15 February 2017 to check that the service now met the legal requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Heathside Neurodisability Unit’ on our website at www.cqc.org.uk.

At our inspection of 14 and 15 February 2017, we found the registered manager and provider had followed their plan and met the legal requirements in relation to staffing. Staff were supported in their role and received regular supervision and appraisal of their performance. Any gaps identified in staff’s knowledge were addressed to enable them to undertake their roles.

The service had a registered manager in post . A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were safe living at the service. Staff knew how to protect people from abuse. Staff had received training in safeguarding adults and understood their responsibilities to report any concerns.

Staff assessed people’s needs and identified risks to their health. Support plans were developed and had sufficient guidance for staff on how to manage the risks and to support people make progress towards independent living. Staff attended regular training and had the relevant skills and knowledge to meet people’s needs effectively.

People gave consent to care and treatment. Staff supported people in line with the requirements of the Mental Capacity Act 2005. ‘Best interests’ meetings were held to support people unable to make decisions about their care.

People were treated with kindness and compassion. Staff respected people’s dignity and maintained their privacy. People received care that was individualised as staff knew them well. Staff had information about people’s preferences and knew about how they wanted their care provided.

People, their relatives were appropriate and healthcare professionals were involved in planning and making decisions about their care. Staff carried out regular reviews of people’s health and the support they required. People received care responsive to their individual needs.

The service had a complaints procedure in place and people knew how to make a complaint if needed. People and staff views were considered and their feedback was used to drive improvement at the service.

There was an open culture at the service. The quality of the service was reviewed regularly and improvements made when required. The service worked closely with other healthcare professionals to deliver good quality care.

We carried out an unannounced comprehensive inspection of the service on 18 November 2015. The service was in breach of regulations related to staff support. Staff were not provided with regular supervision and appraisal as required. We also found that PRN protocols were not in place to ensure that people were given their medicines as prescribed. A PRN protocol explains how people should receive their medicines that were to be taken only when they needed it, such as pain killers. Following our last inspection the service had provided us with an action plan telling us how they were going to ensure that the concerns raised were addressed. This report only covers our findings in relation to those legal requirements that were not met by the provider at our previous inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Heathside Neurodisability Unit on our website at www.cqc.org.uk.

At this inspection we found that the service had addressed some of the concerns we raised, but required further improvement in supporting staff. Staff were not provided with regular appraisal meetings to review their performance and address skill gaps to ensure effective service delivery for people.

Staff told us they received regular supervision that enabled them to carry out their responsibilities as required. Staff had support to identify and address their professional development needs as necessary. Records showed that staff‘s knowledge was assessed during the supervision sessions. This meant that staff’s performance was in line with good practice.

People had individual PRN protocols in place, which ensured they were supported to take their medicines safely. Staff easily accessed PRN protocols for information when required. The service followed appropriate record keeping procedures to ensure that information about PRN medicines taken by people was accurate and available to the team.

We found that there were individualised care plans in place, and that each person using the service had a clearly set out therapy programme.

We saw that the unit had appropriate equipment in place to enable staff to carry out their rehabilitation work. The staff team included physiotherapists, occupational therapists and a social worker. The unit worked closely with other health professionals including speech and language therapists and nutritionists.

There were effective recruitment and selection processes in place. Staff were appropriately vetted before starting work in the unit and all required pre-employment documentation was in place.

We saw that there were a number of internal audits being carried out at regular intervals, to assess the quality of care being provided and to identify any potential risks to people's health, welfare and safety.