The Elton Unit - The Priory Highbank Centre

The Elton Unit is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Elton Unit is a detached single-storey purpose built adult continuing care facility situated five miles away from the Priory Highbank Centre. It provides support specialist treatment, care and support for people who have complex neurological and behavioural needs.

The Elton Unit is situated in a residential area of Bury yet close to open countryside. It is part of the Priory Rehabilitation Services Group and is registered to care for up to 28 adults with an acquired brain injury. The unit is set in well-maintained gardens with adequate parking and clearly defined parking areas for disabled visitors. There were 26 people using the service at the time of our inspection.

The home had a manager registered with the Care Quality Commission (CQC) who was present on the day of the inspection. A registered manager is a person who has registered with CQC 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 and associated regulations about how the service is run.

Staff had received training in safeguarding adults. They could tell us of the action they would take to protect people who used the service from the risk of abuse. They told us they would also be confident to use the whistleblowing procedure in the service to report any poor practice they might observe. They told us they were certain any concerns would be taken seriously by the registered manager. We received positive feedback about the service from the local authority and clinical commissioning group safeguarding leads.

Systems were in place to ensure staff were safely recruited. Staff demonstrated a commitment to providing high quality personalised care for the individuals who lived at the home. People were supported to achieve their rehabilitation goals.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes were recorded.

We looked around the building and found it was secure, had been maintained, was clean and hygienic and a safe place for people to live and work in. We found equipment had been serviced and maintained as required. Procedures were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and water supply.

We found medication procedures at the home were safe. Nurses responsible for the administration had the competency and qualifications required. Medicines and controlled drugs were safely kept with appropriate arrangements for storing in place.

Staff told us they received the training and supervision they needed to be able to carry out their roles effectively. Staff received extensive training to allow them to carry out more complex procedures, if they wanted to. Systems were in place to ensure staff received regular support and supervision.

The registered manager had taken appropriate action to apply for restrictions in place in a person’s best interests to be legally authorised.

We saw examples of how members of the staff team worked in partnership with other healthcare professionals employed within the organisation and externally to ensure that people received appropriate care and treatment. Relatives we had contact with told us they were very happy with the care and support their relative received.

People were provided with a choice of suitable nutritious food and drink to ensure their health care needs were met. The staff team worked closely with the dietician and speech and language therapist to ensure people’s needs were safely met.

Staff we spoke with told us they enjoyed working in the service and felt valued by both colleagues and the registered manager.

We observed the management team and staff demonstrated a caring, compassionate and kind attitude towards people who lived at the home. Relatives we had contact with confirmed this.

Systems were in place to enable people and their family and friends to request support and seek information and advice about welfare benefits and independent advocacy.

Care plans were in place to help ensure staff provided the level of support necessary to manage the identified risks. Care plans were regularly reviewed to address any changes in a person’s needs.

An important aspect of people’s care was to involve them in the planned programme of activities to enable them to participate in facilities both in the community and at the Elton Unit, despite how complex this may be

The complaints procedure was clearly displayed and relatives told us they would have no problem raising any issues of concern if they needed to.

The service had a longstanding registered manager in place who was said to be visible, knowledgeable, approachable and supportive and was well respected by staff.

Staff spoke positively about working at The Elton Unit and felt that management responded well to the needs of staff and to people who used the service. We found that the managers and staff demonstrated a commitment to continuing to drive forward improvements in the service.

There were processes in place to monitor the quality of the service provided to ensure people received safe and effective care.

We saw that the patients' care records contained detailed information to show what treatment was to be provided and how they were to be supported and cared for. The care records also showed that systems were in place to protect those patients who lacked the capacity to make decisions about their own treatment, care and support.

An inspection of the care records showed that the patients had access to other health and social care services. We were also made aware of the systems that were in place to make sure that information was passed on when a patient's care was transferred to another service.

We walked around all areas of the building and saw that the unit was clean, well lit and free from offensive odours. The design, layout and maintenance of the unit ensured that patients, staff and visitors were kept safe.

The patients were well cared for by staff who were properly trained, supported and supervised.

People's care records contained detailed information to show how people were to be supported and cared for and how their dignity and privacy were to be respected.

Systems were in place to help protect people by ensuring that staff were suitably trained in the safeguarding of vulnerable people. Staff told us they would feel confident in reporting any issues of abuse. One member of staff told us, 'The patient is number one at the end of the day.'

The medication system was safe and people received their medicines safely and as prescribed.

People were cared for by skilled and experienced staff.

Regular monitoring of the services and facilities provided was in place to help protect people against the risks of inappropriate or unsafe care.