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Hunters Moor Neurorehabilitation Centre for the West Midlands - The Janet Barnes Unit Good

Inspection Summary


Overall summary & rating

Good

Updated 15 July 2016

  • We rated Janet Barnes unit as Good because
  • Treatment was effectively organised to help maximise patient recovery and potential.
  • Patients had access to good physical and psychological healthcare.
  • There was effective team working to integrate physical, cognitive, and psychological recovery.
  • There were sufficient staff to ensure patient safety.
  • The service learned from past incidents and complaints to improve.
  • Overall, staff were positive and encouraged patient recovery and well-being.
  • Patients and relatives were involved in and informed of treatment and progress.
  • Patients and relatives were able to raise any concerns or complaints and have them addressed.
  • There was good medicine management.
  • Patients’ rights were safeguarded whilst on the unit.
  • The unit was clean and well-maintained.
  • Patients, relatives and staff were positive about the new manager, who they saw as approachable, involved and responsible for improvements in the running of the service. It was clear that, under the new manager, the service had made major improvements since the previous inspections.

However,

  • Not all staff received regular supervision to help support them in carrying out their duties effectively.
Inspection areas

Safe

Good

Updated 15 July 2016

We rated safe as good because

  • The unit was clean, and furnished and maintained to a high standard.

  • Call bells and alarms were in place and staff responded promptly.

  • There were sufficient staff on duty to ensure patients were safely monitored and supported.

  • Staff were trained to use effective de-escalation techniques to help keep patients calm and safe.

  • There was sufficient medical cover to keep patients safe.

  • Patients had risk assessments that the service completed upon admission and updated in a timely manner. The service used recognised monitoring tools to ensure patients were safely cared for.

  • The service applied for Deprivation of Liberty Safeguards as appropriate. This helped ensure that the service protected patients without unduly restricting their liberties.

  • Staff used clear observation protocols to keep patients assessed as at risk safe.

  • The service was diligent and transparent in raising safeguarding concerns.

  • There was good, safe management of medicines.

  • The service learned from past mistakes in order to improve the service.

    However,

  • It was not clear whether rehabilitation assistants benefitted from sharing in any learning from incidents or mistakes.

  • It was not clear if all portable appliance testing was up to date, as details on some stickers were illegible.

Effective

Requires improvement

Updated 15 July 2016

We rated effective as requires improvement because:

  • While clinicians received regular professional supervision, unqualified care staff received infrequent or no supervision.

  • While clinicians were positive about training and were able to access relevant specialist training, rehabilitation assistants were less positive about training, particularly the lack of specialist training to meet the specific care needs of patients.

However,

  • Patients had good access to physical healthcare. Physical health checks took place regularly.

  • Recognised monitoring and assessment tools were used to chart and support patient recovery.

  • Care records were up to date, and guided and reflected good care and treatment.

  • Medicines management was effective and supported treatment and patient well-being.

  • Treatment followed recognised guidelines and was supported by monitoring tools to ensure optimal outcomes. Physiotherapy and occupational therapy interventions were employed to maximise patient recovery. Psychology support maximised cognitive recovery.

  • A good mix of staff skilled in various disciplines worked together to help patient recovery.

  • The service liaised with local agencies over safeguarding issues.

  • Multi-disciplinary meetings demonstrated the effectiveness of team working. They showed teams being patient focussed and working together to improve patient recovery and well-being.

  • The service considered consent and capacity issues, with best interests meetings and Deprivation of Liberty Safeguard applications in place where appropriate.

Caring

Good

Updated 15 July 2016

  • Overall, staff were very positive and encouraging towards patients, helping them maximise their recovery potential.

  • Patients and carers were very positive in their views of staff. They were particularly impressed by the progress patients made with the support of clinicians and therapists.

  • Clinical staff and nurses showed a good understanding of the individual needs of patients.

  • Patients were involved in their care and treatment, principally by discussion with clinicians and therapists. Patients and relatives showed a good awareness of treatment plans.

    However,

  • We observed two rehabilitation assistants moving a patient while making very little verbal or other interaction with them.

Responsive

Good

Updated 15 July 2016

We rated responsive as good because;

  • Patients were able to remain at the unit for sufficient time to enable effective treatment and recovery. This was monitored to meet individual need.

  • Discharge was rarely delayed for non-medical reasons.

  • The unit had a suitable range of rooms and facilities to support treatment and care.

  • Patients could personalise rooms, had safe storage for possessions and had access, with staff support if required to hot drinks and snacks at any time.

  • There were facilities to meet with relatives and other visitors.

  • Therapeutic and treatment activities were an integral part of each patient’s individual recovery plan and took place regularly, in accordance with individual patient plans.

  • Information about the service was freely available for patients and carers.

  • Patients and carers were able to raise concerns and complaints. The service responded to complaints and took action where complaints showed shortfalls.

    However,

  • Although there was a mini-bus to facilitate patient activities and appointments, this was rarely used, owing to a shortage of drivers.

Well-led

Good

Updated 15 July 2016

We rated well-led as good because:

  • Staff, patients and relatives were very positive about the new manager, who had been in post for six months. People we spoke with said he was approachable and supportive. We noticed considerable improvements in the service, particularly in areas that were previously non-compliant.

  • Staff, patients and relatives were very positive about the new manager, who had been in post for six months. People we spoke with said he was approachable and supportive. We noticed considerable improvements in the service, particularly in areas that were previously non-compliant.

  • Systems were much improved. For example, the unit had greatly improved medicines management, with clear recording and checking. Care records were clearer and more accessible.

  • There was good teamwork, particularly amongst clinical and therapy teams. This all helped support patient recovery.

  • Although there was still room for improvement, staff training was taking place more regularly, with more staff now receiving training.

However,

  • Supervision amongst unqualified rehabilitation staff was irregular. A number of rehab staff did not appear to be engaged with the service and its aims. Management were putting plans in place to address this.

  • There was no evidence of a survey of staff at Janet Barnes unit.

Checks on specific services

Services for people with acquired brain injury

Good

Updated 15 July 2016