14 - 15 January 2015
During a routine inspection
We inspected this service on 14 January 2015. This was an unannounced inspection.
The service was registered to provide accommodation and personal care for up to 33 people. People who use the service remained patients at the University Hospitals of North Midlands NHS Trust, but are transferred to the unit because their health needs no longer require treatment within a hospital setting. Most people who use the service require a short period of rehabilitation before they are discharged to their own home or to a care home.
At the time of our inspection 32 people were using the service.
The service had a registered manager. 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 and associated Regulations about how the service is run.
We identified that improvements were required to ensure people received their medicines safely.
People’s risks were assessed and there were sufficient numbers of staff to promote people’s safety. However, care records did not always show that risks were reviewed when required to ensure people’s safety was consistently promoted.
Some people were unable to make certain decisions about their care and one person had their movements restricted within the unit’s environment to keep them safe. The Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) set out requirements to ensure where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves. We found that the staff did not always apply their knowledge of the Act and the DoLS to manage the restrictions they placed on people. This meant that the staff did not always follow the legal requirements in place to ensure decisions were made in people’s best interests.
People received sufficient amounts of food and drink. However, people’s dietary care plans were not always followed. This meant people’s risks of malnutrition and dehydration were not always being managed as planned.
The staff had received training that enabled them to meet people’s needs. Care was provided with kindness and compassion and people’s independence and dignity were promoted. Support and advice was also offered to people’s relatives as required.
People’s health and wellbeing were monitored and staff worked with other professionals to ensure people received medical, health and social care support when required.
People were involved in the assessment of their needs and care was provided in accordance with people’s care preferences. People were encouraged to participate in their preferred activities to reduce the risk of isolation or boredom.
The provider listened to and acted upon feedback from people who used the service to improve care. As a result of feedback, plans were in place to improve people’s involvement in the planning of their rehabilitation and discharge needs.
There was a positive and enabling culture within the unit and an effective management structure was in place to support the staff and improve the quality of care.
The registered manager had identified where improvements were required and was working on making the required improvements.