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Archived: Chase Park Neuro Centre Requires improvement

The provider of this service changed - see old profile

The provider of this service changed - see new profile

Reports


Inspection carried out on 4 & 7 September 2015

During a routine inspection

This was an unannounced inspection carried out on 4 and 7 September 2015.

We last inspected Chase Park Neuro Centre in October 2014. At that inspection we found the service was meeting all the legal requirements in force at the time.

Chase Park Neuro Centre is registered to provide care to 60 people aged 18 years or over. The site is split into two locations, one which provides rehabilitation to people with a neurological condition and one which provides specialist nursing care to people with a neurological condition together with a service user group of older people.

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.

People said they felt safe. We had concerns however that there were not enough staff on duty to provide safe and individual care to people.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

People did not always receive their medicines in a safe way.

Not all areas of the home were clean and well maintained for the comfort of people who used the service. Equipment was not always available to meet people’s needs.

Staff undertook risk assessments where required and people were routinely assessed against a range of potential risks, such as falls, mobility, skin damage and nutrition. However, risks were not all regularly reviewed to reflect current risks to the person.

Staff were provided with training to give them some knowledge and insight into the specialist conditions of people in order to meet their care and support needs. People had access to health care professionals to make sure they received appropriate care and treatment.

Regular staff knew people’s care and support needs. However care records we looked at were not all up to date. They lacked evidence of regular evaluation and review to keep people safe and to ensure all staff were aware of their current individual care and support needs.

People received a varied and balanced diet.

People said staff were kind and caring. However we saw staff did not always interact and talk with people when they had the opportunity. There was an emphasis on task centred care.

There was a programme of entertainment and activities provided by the activities person, however when they were not available, other staff did not provide activities for people to remain stimulated. People we spoke with and relatives said more activities and stimulation needed to be provided for people.

People and their relatives had the opportunity to give their views about the service. A complaints procedure was available.

The home had a quality assurance programme to check the quality of care provided. However, the systems used to assess the quality of the service had not identified all the issues that we found during the inspection to ensure people received individual care that met their needs.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 2 October 2014

During an inspection to make sure that the improvements required had been made

The reason for this visit was to check if improvements had been made to help promote the respect and involvement of people who use the service and to see if staffing levels had been increased. We considered our inspection findings to answer questions we always ask:

- Is the service safe?

- Is the service caring?

- Is the service well-led?

-Is the service responsive?

-Is the service effective?

This is the summary of what we found.

Is the service safe?

We saw there were arrangements in place to ensure there were enough staff on duty to ensure the needs of people were met in a safe and timely way.

Is the service caring?

We saw there was more involvement and consultation with people who used the service. Records showed people were provided with opportunities for social activities and outings. We saw staff were attentive and engaged with people in a kind and caring way. People we spoke with said staff were kind although they were kept busy.

Is the service well-led?

We saw a new manager had been employed since the last inspection. We were told the manager was making an application for registration with the Commission as the manager of this location, in line with the requirements of the registration of the service. They told us the ethos of the service was to promote the involvement of staff and people who use the service in decision making wherever possible. We saw the action that had been taken and the plans for improving quality outcomes for people who use the service. For example with regard to activities and outings, staffing and ensuring the environment was suitable to help maintain the independence of people who lived with dementia.

We saw there was more focus from management on the provision of individual care and support to people who used the service including people who lived with dementia or cognitive impairment.

Is the service responsive?

This was a responsive inspection to previous non-compliance against the regulations and we did not look specifically at this area.

Is the service effective?

This was a responsive inspection to previous non-compliance against the regulations and we did not look specifically at this area .

Inspection carried out on 9 May 2014

During a routine inspection

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

This inspection took place out of hours in the evening.

We considered our inspection findings to answer questions we always ask:

. Is the service safe?

. Is the service effective?

. Is the service caring?

. Is the service responsive?

. Is the service well-led?

This is the summary of what we found.

Is the service safe?

An assessment of people's care and support needs was carried out before people started to use the service. This was to ensure staff had the skills and had received the training in order to safely meet the person's support requirements.

Risk assessments were in place. People were supported and encouraged to maintain their independence and this was balanced with the risk to the person. Audits were carried out to look at accidents and incidents and the necessary action was taken to keep people safe.

Information was available to show that the service worked with other agencies to help ensure people's health needs were met and to prevent admissions to hospital wherever possible.

We saw there were not enough staff on duty at the time of inspection, we were told this was because a staff member had mistakenly reported for the wrong shift and replacement cover was not available.

Is the service effective?

We are aware the organisation primarily provides a specialist service to people with acquired brain injuries, however as the nursing service also provides care to some older people with dementia and cognitive impairment the service was not well equipped to meet these specialist needs. The environment was not suitably designed to meet these needs and there was little evidence of the involvement of people with dementia in daily decision making about their care needs.

People commented how helpful and friendly the workers were. Relatives told us the service kept them up to date with what was happening with their relative's care and they felt able to ask any questions. One person we spoke with commented how pleased they were with the care provided by staff at the home.

Staff on the whole were observed to be patient and supportive as they worked with people.

Is the service caring?

Most people and relatives spoken with talked well of the level of care provided by staff. We found people with dementia or cognitive impairment were not sufficiently involved in daily decision making. Staff were helpful and offered people information and support about their care. We observed most staff interacted well with people and it was evident that staff had developed a good understanding of people’s communication needs and how best to communicate with them. However due to the low staffing level, on the top floor at the time of inspection, staff had little, or no time to spend interacting and engaging with people.

Is the service responsive?

Information was collected by the service with regard to the person's ability and level of independence before they moved into the service. Various assessments were completed by the manager of the service with the person and/or their family to help make sure staff could meet their needs. Regular reviews were carried out with the person who used the service and their representative to make sure plan's of care were kept up to date. This helped ensure staff provided the correct amount of care and support.

Referrals for specialist advice were made when staff needed guidance to ensure the health needs of people were met.

People's individual needs were taken into account and they, or their representative if they were not able, were involved in decision making with regard to their care. They were kept informed and given some information to help them understand the care and choices available to them, however this was not developed sufficiently to involve people with dementia.

Information collected by the service gave staff some insight into the interests and areas of importance to the person. Activity provision was not sufficiently developed to help ensure activities reflected people's interests and provided stimulation to people with dementia if they wished to become involved. Activity provision and opportunities for socialisation were not offered by support workers when activities personnel were not on duty. Staff we spoke with and people who used the service said there was little time for any socialisation and engagement as staff were kept so busy with other tasks.

Regular meetings took place with staff and people who used the service and their relatives to discuss the running of the service and to ensure the service was responsive in meeting the changing needs of people.

Is the service well-led?

There was a focus from management on the provision of individual care and support to people who used the service. However there was less emphasis about individualised care and support to people with dementia and cognitive impairment. Staff were knowledgeable about the support needs of people.

Most staff commented they felt supported by the manager and advice and support was available from the management team.

We saw people had the opportunity to comment on the quality of the service and that they felt able to speak to the manager and staff about any issues.

During a check to make sure that the improvements required had been made

At the last inspection of May 2013 we said the provider was not compliant with this outcome as there were not enough qualified, skilled and experienced staff to meet people's needs.

A previous inspection identified that action was needed to increase staff levels overnight on the nursing unit of the service. We said that three support workers were not enough to cover both floors of the unit. We found that action had been taken to increase these staffing levels to make sure the needs of the people could be met in a safe and individual way.

The manager provided us with evidence of staffing levels and the numbers of people who lived on the nursing unit. They also showed us the assessment tools they used to work out the dependency levels of people who used the service.

We saw there were now enough staff on duty overnight to provide individualised care and support to people who used the service.

Inspection carried out on 13, 28 May 2013

During a routine inspection

We decided to visit the home at 7:30pm to gain a wider view of the service provided. This was part of an out of normal hour’s pilot project being undertaken in the North East region.

We spoke to seven people who used the service and a relative who said they were pleased with the care and support provided by the home. They said the staff were kind and caring. One person said; "The staff are brilliant."

People told us they were well cared for. Another person said, "The staff are very good."

We found that care was planned in a way that ensured people's safety and welfare. However staffing levels at night were not sufficient to ensure people's safety and welfare.

The premises were well maintained and a programme of refurbishment was in progress and people we spoke with told us they were kept informed and involved.

Staff received professional development and people told us staff were well trained. Staff comments included:" There are very good opportunities for training."

We saw the provider had systems in place to gather feedback from people, who used the service, and to regularly assess and monitor the quality of service people received.