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Inspection Summary


Overall summary & rating

Good

Updated 21 April 2017

This inspection took place on the 24th and 25th of January 2017. It was unannounced on the first day and announced on the second.

TRU ABI rehabilitation centre offers support for up to 30 people who have an acquired brain injury. The service can provide care for people who are detained under the Mental Health Act 1983. The service is based in a rural setting, in the area of Haydock, which is located between Liverpool and Manchester. There is easy access via motorway networks with car parking on site. The centre is purpose-built to be fully accessible for people with physical disabilities.

The service comprises three units, Newton, Willows and Lowton. The Newton unit accommodates people who have been detained under the Mental Health Act. Because of this the unit was inspected by inspectors from the hospitals (mental health) inspection team.

At the time of our inspection there were two people living in the Newton unit, six people living in the Willows unit and four people living in the Lowton unit.

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.

At the last inspection on the 16th and 17th of June 2015 there were three breaches of regulation in relation to the safe management of medicines, the management of complaints and ineffective audit systems. We asked the registered provider to take action to address these areas.

After the inspection, the registered provider sent us an action plan that specified how they would meet the requirements of the breaches identified. They advised us that they would meet all the legal requirements by February 2016. During this inspection we found significant improvements had been made across all areas and the registered provider was able to demonstrate full compliance with the Health and Social Care Act 2008 (Regulated Activities) 2014.

Medicines were managed safely and clear processes were in place that ensured people received their medicines on time and ‘as required'. Medicines were stored, administered and recorded in accordance with the registered provider's policies and procedures. All staff administering medicines undertook annual competency assessment and training.

People knew how to raise concerns and complaints, and felt confident to do so. Records showed people were fully involved with the complaints process and the registered provider followed their procedures.

Improvements were demonstrated within the registered provider’s quality assurance systems. Action plans evidenced areas for improvement and development and these were addressed in a timely manner. Actions were signed and dated when completed. People's feedback was sought and the management team used this for service development.

We have made a recommendation for clinical supervision to be undertaken with staff working within the Newton Unit.

The service demonstrated safe recruitment practices. All new staff undertook appropriate checks prior to them commencing employment. All new staff received a thorough induction which included a period of time shadowing experienced staff. All staff received regular mandatory training to ensure they remained up to date with their knowledge and skills required for their role. There were sufficient staff to meet the needs of the people living at the service.

People's needs were assessed prior to them moving into the service. Individual risk assessments were completed to ensure people and staff were protected from the risk of harm. Staff promoted people's independence wherever possible. Care plans were person centred and gave clear guidance to staff to meet people's individual needs.

All staff had received regular training in adult safeguarding and were able to demonstrate a good understanding of how to recognise and report signs of potential abuse. There were clear policies and procedures in place that informed staff of how to keep people safe and these were followed.

People were supported to participate in activities of their choice. People spoke positively about the way staff treated them and said that they enjoyed spending time with staff. We observed positive interactions between staff and people living at the service.

Inspection areas

Safe

Good

Updated 21 April 2017

The service was safe.

There were sufficient numbers of staff to meet the needs of the people at the service. The registered provider had robust recruitment procedures in place.

Medicines were administered, stored and recorded by competent staff.

People were supported by staff who had received safeguarding training and understood how to recognise and report any signs of abuse.

Effective

Good

Updated 21 April 2017

The service was effective.

People were supported by staff that had the right competencies, knowledge and skills to meet individual needs.

The registered provider had effective systems in place to assess people's ability to make their own decisions under the Mental Capacity Act 2005 (MCA).

People told us that they had access to sufficient food and drink and staff ensured they had access to healthcare professionals.

Caring

Good

Updated 21 April 2017

The service was caring.

Staff built positive relationships with people and were given enough time to meet people's individual needs.

People were supported by staff. Staff promoted people’s independence.

People had access to advocacy services and the registered provider had a policy to support this.

Responsive

Good

Updated 21 April 2017

The service was responsive.

Care records were person centred and focused on the individual. Staff demonstrated a good understanding of how people wanted to be supported.

People were supported to undertake activities of choice and maintain hobbies and interests.

People knew how to raise concerns and complaints and felt confident to do so.

Well-led

Good

Updated 21 April 2017

The service was well led.

The registered provider had effective audit systems in place to ensure areas for development were identified and addressed.

Feedback had been sought from people living at the service to identify areas of improvement and these had been actioned.

The registered provider had appropriately informed the CQC of certain events as required by law.