Summerfield Court

Summerfield Court accommodates up to 17 people in a rehabilitation home for people who have acquired a brain injury. At the time of our inspection, 17 people were using the service. All bedrooms within the home had en-suite facilities and the provider also had an annex with three apartments which provided a more independent living environment for people planning to move into assisted living accommodation in the community.

This inspection took place on 24 April and 01 May 2018. The inspection was unannounced on the first day. This meant the staff and provider did not know we would be visiting. The second day was announced.

A registered manager was 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.

Records were not always accurate to show when actions had been taken to improve the quality of care being provided and therefore, we have made a recommendation about records management.

People told us they felt safe and staff had a clear understanding of how to protect people from abuse or harm. Safeguarding and whistleblowing policies were in place which staff followed should concerns need to be raised.

Medicines were managed safely and we saw people received their medicines with signatures to show when they had been administered. ‘As required’ medicines were administered when needed and some people were supported to self-administer.

Risk assessment were completed and regularly updated to reflect people’s needs. Accidents and incidents were reported and actions taken to mitigate future risks. Safety checks had been carried out to ensure the home was safe and regularly monitored.

Staffing levels were sufficient to meet people’s needs. Robust systems were in place to ensure people working in the home were of suitable character.

The provider followed the Mental Capacity Act 2005 (MCA) guidance with capacity assessments, Deprivation of Liberty Safeguards (DoLS) applications made and court of protection orders followed. Staff also understood MCA guidance and supported people to make decisions when possible.

People were supported with their nutrition and health needs. Specific dietary plans had been created with health professionals for those that required further support. Health care professionals were involved to ensure people were supported in their recovery and advise staff on practice when needed.

Staff received sufficient training to ensure they could support people’s needs. Supervisions and annual appraisals were completed to promote development and staff told us they felt supported.

People living in the home spoke positively about the staff that supported them and thought of them as friends. People told us they were involved in all aspects of their care and were provided explanations to ensure they understood their care.

Staff respected people’s privacy, dignity and preferences. People’s wishes, likes and dislikes were considered when developing care plans and people were encouraged to remain independent to aid their recovery.

Care plans were person centred and focused on people’s independence and encouragement to move on from the home to assisted living environments within the community. Care plans were regularly reviewed in collaboration with people who were offered choices about how they wished to live their life.

The use of technology and accessible information was available for those people who needed it and improved communication between people.

Activities were actively encouraged to ensure people did not become social isolated and to support people to partake in hobbies or interests they enjoyed.

People knew the registered manager and felt actions would be taken should any concerns be raised. People and staff told us the registered manager had an open door policy and was approachable.

Audits and surveys were completed to gather people’s views and ensure improvements were made however, records did not show the actions taken.

Monthly meetings for staff and people living in the home took place to ensure people could express their views and be informed of any changes within the home.

The provider continuously sought to improve people’s quality of life by supporting them in their goals to aid recovery and enhance independence skills to move into the community.

Summerfield Court provides a rehabilitation service for up to 17 people with an acquired brain injury. The service is situated in Bramley, which is on the outskirts of Leeds, and has on-site parking and a garden area. It is close to local shops and public transport. We saw the home had a gym room, pool table and art and creative writing space.

At the time of our inspection the service had a manager who was going through the registered manager’s process. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

At this inspection we found some aspects of medicines management were not always followed. Records did not always show when creams and lotions known as ‘topical medicines was applied and how often.

We saw from the staff records we looked at that supervision and appraisals had not been carried out on a regular basis. The manager told us staff supervision should take place at 3 monthly intervals.

We found there were enough staff to make sure people received appropriate care and support. Recruitment checks had been carried out on all staff to ensure they were suitable to work in a care setting with vulnerable people.

Staff knew how to keep people safe from the risk of harm and abuse; they had received relevant

safeguarding training and knew how to report issues of concern.

We found people's health care needs were met and relevant referrals to health professionals were made when needed.

People's nutritional needs were met. There were choices available on the menus and alternatives if people didn't like what was on offer. Nutritional risk was assessed and people’s weight was consistently monitored.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom. We saw appropriate DoLS authorisations had been made for people the service had identified were likely to have their liberty deprived.

When people were assessed as lacking capacity, staff acted within the principles of the MCA and ensured important decisions were made within best interest decision making processes.

Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.

People told us they were treated with kindness and compassion. Our observations of care and support confirmed this. People told us they were happy with the care provided.

Staff responded to people’s individual needs and delivered personalised care. People’s care plans and other records showed their needs had been initially assessed, and care was planned. However, we found care plans reviewed were incomplete and not always updated.

The home looked well maintained, clean and tidy, and checks were carried out to make sure the premises and equipment was safe.

A range of activities were offered for people to participate in and people told us they enjoyed these.

There were systems in place to ensure complaints and concerns were fully investigated. The manager had dealt appropriately with any complaints received.

A range of checks and audits were undertaken to ensure people's care and the environment of the home was safe and effective. These checks had identified the issues we noted around the management of medicines but the service had not responded robustly and these were still occurring.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to staffing. You can see what action we told the provider to take at the back of the full version of the report.