Luton Intermediate Care and Rehabilitation Service

Luton Intermediate Care Rehabilitation Service (LICRS) provides community health services for adults over and under 65 years from two sites. The service provides rehabilitation for people within their own homes, who have had a stroke; rehabilitation in a 20 bedded unit at Capwell Grange, Luton for people who have suffered from illness or an accident and a county wide acquired brain injury service that strives to ensure that people who have complex needs following an acquired brain injury receive timely, person centred rehabilitation.

Our rating of this location improved. We rated it as outstanding because:

• Staff completed risk assessments for each patient on admission or engagement with the service, using a recognised assessment tool, and reviewed this regularly, including after any incident. We reviewed ten risk assessments during the inspection and saw that this was the case.
• Outcomes for patients were positive, consistent and met expectations, such as national standards. Staff used a nationally recognised outcome measure which measured patients’ abilities. Staff at LICRS used a functional independence tool to measure levels of independence for self-care. We saw that in the previous quarter, July- September, independence levels between admission to the service and discharge from the service rose by 26 points and 24 points in the previous quarter.
• Staff were experienced, qualified and had the right skills and knowledge to meet the needs of patients. Managers told us about a robust recruitment process to ensure that high calibre staff were employed by the service. We saw that 19% of the workforce were on apprenticeship programmes, two staff were undertaking the assistant practitioner level five, two staff were undertaking the operations manager level five and four staff were undertaking the team leader level three.
• Staff received and kept up-to-date with their mandatory training. Mandatory training levels were at 92% at the time of the inspection. The mandatory training was comprehensive and met the needs of patients and staff.
• The approach of staff promoted a strong person centred approach and staff recognised the personal, social, physical and holistic needs of their patients. We observed a multi-disciplinary team meeting during the inspection and heard that staff identified concerns within the wider family which might impact on the patient’s recovery. Staff were discreet and responsive when caring for patients. Staff took time to interact with patients and those close to them in a respectful and considerate way. Patients said staff treated them well and with kindness. We spoke with four patients and all spoke highly of the service and the caring supportive staff.
• Staff made sure patients and those close to them understood their care and treatment. With the patients’ consent staff explained care and treatment to carers as well as patients and written information was provided. Staff found innovative ways to enable people to manage their own health and care when they could and to maintain independence as much as possible. We saw that staff asked the patient’s’ permission to move household clutter to assist with service delivery and patients were given the choice on where they wanted to be assessed and what gender they preferred for the staff that visited. Staff also took great care to be mindful of peoples, religious and cultural choices along with any caring responsibilities and other relevant family dynamics.
• Staff planned patients’ discharge carefully, particularly for those with complex physical, mental health and social care needs. They ensured that referrals were made to other services when required and families and carers were kept informed. Staff attended patients’ homes prior to discharge from the rehabilitation unit to assess the patients’ home needs and provide a trial run for the patient to support their discharge. Staff made timely referrals, such as to district nurses to support patients ongoing needs at home
• Luton Intermediate Care Services had values which they believed helped them to constantly strive for outstanding care. They were: Think-drive for better, challenge and learn; Care - deliver a heartfelt service, inspire, understand and communicate and Do - team spirit, accountability and resilience. We observed that staff reflected these values in their behaviour and their approach used when caring for patients.
• There was compassionate, inclusive and effective leadership at all levels. Leaders demonstrated the high levels of experience, capacity and capability needed to deliver excellent and sustainable care. There were consistently high levels of constructive engagement with staff and with the people who used services, including all equality groups. Leadership development was deeply embedded into the service and there was a strong culture of staff development across all levels of service.
• The organisation had robust systems and processes in place to manage current and future performance. There was an effective and comprehensive process to identify, understand, monitor and address current and future risks. The organisation routinely reviewed its processes and ensured that staff at all levels had the skills and knowledge to use all systems effectively.