Mardon Neuro-rehabilitation Centre

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last inspection the service was rated as outstanding. At this assessment the rating remained outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours consistently demonstrated discretion, respect and responsiveness when interacting with people, ensuring individuals received timely assistance, emotional support and advice whenever needed. Relatives and carers spoke highly of the care provided, particularly by healthcare assistants, describing the emotional and practical support they offered as exceptional. We were given several examples of staff going above and beyond their expected roles to meet people's needs and enhance their wellbeing.

One family member told us staff were highly knowledgeable and able to effectively resolve issues because they had developed a thorough understanding of the person’s individual needs and preferences. Another carer explained healthcare assistants provided valuable psychological and emotional support to their relative, who would not otherwise engage with or seek help from mental health professionals. These examples demonstrated the strong, trusting relationships staff had built with the people they supported and their commitment to delivering person-centred care.

Staff supported patients and carers to understand and manage their care, treatment or condition. Staff were supported to take their own medicines and families were supported and provided with education in how to deal with their loved ones.

The service and staff maintained the confidentiality of information about patients. The layout of the unit supported privacy and dignity. We observed staff treating patients with dignity and respect. We observed staff shutting patient doors to maintain privacy and dignity.

We scored the service as 4. The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s care and treatment was personalised to meet their individual needs. Care plans were developed collaboratively with patients and their families, ensuring personal preferences and goals were considered. One patient commented they “didn’t feel hospitalised” and described staff as caring and attentive, consistently ensuring their needs were met. A relative shared that staff supported their family member to watch their preferred television programmes and, recognising that they were unable to operate the remote control independently, routinely asked what they wished to watch and assisted accordingly.

Staff promoted a personalised environment by ensuring photographs of important people, pets, and significant life events were displayed in patients’ bedrooms. One family member confirmed staff actively facilitated this.

Staff demonstrated a good understanding of the challenges associated with neurological rehabilitation, particularly neurological fatigue. They consistently checked how patients were feeling and adapted therapeutic interventions accordingly. For example, when patients were fatigued in the afternoon, staff discussed whether they wished to continue with therapy sessions, ensuring care remained responsive to their needs and preferences.

There were family and friends feedback leaflets displayed in reception and QR codes to provide feedback. Complaints leaflets and posters were also available. This was used by the management team to improve patient care.

We scored the service as 4. The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People were supported to exercise choice and maintain control over their own care wherever possible, enabling them to make informed decisions about their treatment and rehabilitation. Relatives were actively involved and kept informed of progress, developments, and expectations throughout the patient's journey. Regular goal-setting meetings ensured both patients and their families had opportunities to contribute to care planning and remain updated on outcomes and next steps.

Staff demonstrated a clear understanding of the importance of effective communication and family involvement when appropriate. They described the need to manage and, at times, navigate complex family dynamics to ensure the patient's wishes remained central to decision-making. We saw examples of staff contacting family members to inform them of significant changes in a patient's condition.

Staff told us family members and friends were able to visit patients at any time, as there were no set visiting hours. Patients worked closely with their key worker to identify the individuals they wished to involve in their care and decision-making, including family members and advocates. Staff consistently sought patients' consent before sharing information about their condition with relatives or carers.

Staff reported they had access to sufficient equipment to support patients throughout their rehabilitation and did not experience difficulties obtaining additional equipment required to facilitate safe discharge home. However, some staff felt a greater range of kitchen and personal living aids would further support patients in relearning and practising everyday living skills. When required, staff accessed charitable funding to obtain specialist equipment.

Patients were offered a choice of meals and could select from menu options available on a 2 week rolling cycle. Staff acknowledged some patients staying at the centre for extended periods had expressed a wish for greater variety in the menu. Family members were able to bring in food for patients, and facilities were available within patient areas to enable food preparation and storage.

We observed patients being involved in decisions relating to their care and daily activities. For example, some staff sought patients' permission before moving them to another location in a wheelchair, demonstrating a respectful and person-centred approach to care.

The service offered patients group activities to help with rehabilitation. We observed staff facilitate a trivia game following a meal. Staff recognised patients’ knowledge and contributions and encouraged patients to participate. Staff were patient when waiting for responses. However, not all patients were included in the activity.

We scored the service as 3. The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes.

People told us staff were responsive to their needs and provided support when required. During the inspection, we observed call bells being answered promptly, helping to ensure people received timely assistance. We also observed intentional rounding checks being completed regularly and in a timely manner. This proactive approach enabled staff to monitor patients' wellbeing, address any concerns promptly, and ensure people were not left for extended periods without contact or support from staff.

Food and drink options were tailored to meet each patient's individual needs and preferences. The service had effective systems to identify and record patients' nutritional requirements, including any need for modified food and fluid textures in line with the International Dysphagia Diet Standardisation Initiative framework.

During lunch, we observed 8 patients dining in the communal dining area. Staff supported patients in a respectful and person-centred manner, sitting at eye level to promote effective communication and encourage independence where possible. We also observed a range of adaptive equipment in use, including specialist cutlery and plate guards, helping patients to eat safely and maintain their independence during mealtimes.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

All staff reported feeling well supported while working on the unit. Teamwork was consistently strong, and there was effective communication and collaboration between all staff groups.

Staff had access to a comprehensive range of support services to promote their health, wellbeing, and resilience. Counselling services were available to support staff with work-related concerns, and a free talking therapies service provided access to evidence-based treatments, including cognitive behavioural therapy, for those experiencing stress, anxiety, low mood, or depression. Staff could self-refer directly to this service, enabling prompt access to support.

Additional wellbeing resources included a confidential staff helpline offering advice and support on personal, work-related, financial, and family matters. Financial resilience and support services were also available to help staff manage financial pressures. Staff had access to a health and wellbeing champion, with dedicated training provided for the role. A range of wellbeing and mental health training opportunities were available to staff, including courses on stress awareness, burnout prevention, mental health awareness, and mental health refresher training. These courses could be easily accessed and booked through the trust’s electronic learning system.

Monthly wellbeing events and activities were offered, helping staff build connections, boost morale and feel valued and supported in their day-to-day roles.