Stubble Bank

Stubble Bank is a care home and specialist residential mental health service, which provides treatment and rehabilitation to up to six young people aged between 16 and 30 years. The service is based in a large house in a residential area of North Bury. At the time of our inspection, the service supported five people.

The service supports young people who have a diagnosis of complex or enduring mental health difficulties, and who may have spent a lot of time in hospital or secure settings. The service provides a psychologically informed therapeutic environment in which young people can receive the appropriate therapy to help them recover and reintegrate back into society.

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

We have made recommendations about the safe storage of medicines.

Staff had a good understanding of safeguarding processes. Risk assessments were robust and relevant. Staff were recruited safely. Medicines were managed safely. Systems were in place to reduce the risk of the spread of infection. Accidents and incidents were reported and analysed in a timely manner.

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.

The provider was well organised, and the registered manager had a clear vision for the service. Managers were open and honest in their approach to supporting people. The provider had clearly defined roles and managers and staff were clear about their responsibilities. People were given the opportunity to regularly give feedback to improve service provision. The provider had clear audit processes to ensure good quality care.

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

Rating at last inspection and update

The last rating for this service was good (published 16 September 2021).

Why we inspected

The inspection was prompted in part by notification of an incident. This inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of very high-risk behaviours. This inspection examined those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Recommendations

We have made recommendations about the safe management of some medicines.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Stubble Bank is a specialist residential mental health service, which provides treatment and rehabilitation to up to five young women aged between 16 and 30 years. The service is based in a large house in a residential area of North Bury. At the time of our inspection, the service supported five young people.

The service supports young people who have a diagnosis of complex or enduring mental health difficulties, and who may have spent a lot of time in hospital or secure settings. The service provides a psychologically informed therapeutic environment in which young people can receive the appropriate therapy to help them recover and reintegrate back into society. People usually stay at the service for about two years.

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

Young people received the care and treatment they needed to support their rehabilitation and recovery. The service used evidence-based practice and a range of recognised tools to assess risks and develop individual care and treatment plans. Staff complied with good infection control practices when supporting people such as wearing personal protective equipment. The service managed medicines safely.

The service had a residential support team directed by a multi-disciplinary clinical team based offsite. Staff knew young people’s needs and risks well. Staff received the appropriate training and supervision to help them support people effectively. People received support that gave them maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff worked closely with other health and social care professionals to ensure that young people received appropriate and timely care. Staff developed good working relationships with young people. The service placed a strong focus on developing and maintaining young people’s independent living skills and supported them based on their recovery goals. Young people described the staff as genuinely dedicated and caring.

The service had an open and honest culture and staff showed commitment to achieving good outcomes for young people with complex mental health difficulties. Staff described good team working and communication that helped ensure consistency and continuity of care. Staff found managers accessible and supportive.

Regional and local managers used a range of governance systems, tools and processes to assess the safety and quality of the service and identify areas for further improvement. The service had good partnership working and communication with key stakeholders such as young people’s social workers and commissioners.

Rating at last inspection

This service registered with us on 28 September 2020 and this is the first comprehensive inspection. We undertook a targeted inspection on 29 October 2020 to look at the infection prevention and control measures the service had in place.

Why we inspected

The inspection was prompted in part due to concerns received about risk management practices used by the service and staff. A decision was made for us to bring forward our inspection and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe, Effective and Well-Led sections of this full report.

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.

We found the following examples of good practice.

The home did not admit visitors unless it was for the provision of essential healthcare to residents that could not be provided effectively by telephone or video calls. Visitors entered by appointment only and went to a specific room, which was deep cleaned afterwards. Visitors had to use their own pens to sign the visitors’ book.

Staff held mutual help meetings with residents to discuss the pandemic and safety measures, and to invite and answer their questions. Staff worked collaboratively with residents to ensure the home was a safe and clean environment.

The provider had stopped staff working between homes early in the pandemic to minimise cross-contamination. The home had recruited additional bank staff and did not use agency staff.

The provider exempted staff who were self-isolating or ill with Covid-19 from any absent management processes.

Further information is in the detailed findings below.