Background to this inspection
Updated
16 March 2016
The Henderson Unit is a 24 bedded health and social care reablement unit to help patients recover after a period of ill health. The unit provides an intermediate facility that provides a direct link to community services. The unit is run in partnership with other statutory authorities and is therapy led.
The unit is based on the Julian Hospital site at Bowthorpe road in Norwich and provides a “stepping stone” service for patients that are medically fit to leave hospital but need further support to return home safely. The unit admits patients over the age of 18 that have been discharged from the Norfolk and Norwich University hospital. Patients are encouraged towards independence through occupational therapy, physiotherapy and the use of daily tasks and activities. Henderson is an intensive model with a maximum two-week length of stay.
This was an unannounced inspection undertaken as part of a comprehensive inspection of Norfolk and Norwich University Hospitals NHS Foundation Trust.
Medical care (including older people’s care)
Updated
16 March 2016
Services at the Henderson unit were rated as good overall. Safety was rated as requires improvement , with effective, caring, responsive and well led all rated as good.
Onsite medical support was minimal (two days a week) and had the potential of being compromised out of hours. This was an outstanding concern raised during our previous inspection in March 2015, which had been identified as part of the unit action plan, but was not due to be reviewed unitl February 2016.
Due to the minimal medical provision on site, medications could be prescribed without a patient review by a clinician. Monitoring of DNACPR and capacity decisions was not robustly monitored and there was limited access to certain additional training opportunities for staff such as phlebotomy training and last offices.
Gaps in documentation from governance meetings meant that there was a risk that issues were not being appropriately monitored and progressed and therefore governance arrangements should be reviewed to ensure robust process, documentation and tracking of issues identified
Certain items of equipment and the environment required updating. There was a shortage of profiling beds and pressure relieving mattresses.
Incidents were reported and learning identified and shared with staff. Staffing levels were appropriate for the acuity of patients and agency use was minimal. There was strong team cohesiveness with all members of the multidisciplinary team having input into patient care. Patients were encouraged and actively involved in their care and discharge plans. There was a full and comprehensive list of scheduled activities to support individual reablement programmes.
There were plans underway to convert the large defunct bathroom into a toilet/shower-room and storage areas, although this was in the early stages of planning and funding had not yet been approved.