Care Service Description

35 Ninelands lane is a registered unit that provides rehabilitative support for up to two people with an acquired brain injury. The unit is part of the Daniel Yorath House, which forms part of the nationwide network of rehabilitation support services provided by The Brain Injury Rehabilitation Trust (BIRT) At the time of our inspection there was one person using the service.

Rating at last inspection

At the last inspection, the service was rated Good.

One key question was rated ‘Requires Improvement.’ The service had not always been effective as staff did not always have adequate training or supervision. At this inspection we found the provider had made improvements in these areas.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

People received support which was individual to their needs, and risks were minimised wherever possible. Staff received training and support which helped them be effective in their roles. People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible. The service provider’s policies and systems supported this practice. We observed a relaxed atmosphere in the service, and saw people were free to decide how they spent their time. The registered manager ensured the quality of the service was monitored, and improvements were made when required.

Further information is in the detailed findings below.

This was an announced inspection carried out on the 12 January 2015. At the last inspection in November 2013 we found the provider met the regulations we looked at.

35 Ninelands Lane is a registered unit that provides rehabilitative support for up to two people with an acquired brain injury. The unit is part of the Daniel Yorath House, which forms part of the nationwide network of rehabilitation support services provided by The Brain Injury Rehabilitation Trust (BIRT). At the time of inspection there were two people using the unit. The unit is situated close to local amenities and is used to assess a person’s ability to live independently.

At the time of this inspection the home 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 2008 and associated Regulations about how the service is run.

Staff training provided did not equip staff with the knowledge and skills to support people safely. There was no evidence staff knowledge and competency was checked following completion of specific training courses. This is a breach of Regulation 23 (Supporting workers); Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

People told us they felt safe in the home and we saw there were systems and processes in place to protect people from the risk of harm.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The support plans included risk assessments.

We found people were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

People received their prescribed medication when they needed it and appropriate arrangements were in place for the storage and disposal of medicines.

The home had policies and procedures in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. The clinician understood when an application should be made and the procedure for doing this.

People were appropriately supported and had sufficient food and drink to maintain a healthy diet.

People’s health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made.

We observed interactions between staff and people living in the home and staff were respectful to people when they were supporting them. Staff knew how to respect people’s privacy and dignity.

Staff had good relationships with the people living at the home and the atmosphere was happy and relaxed. People attended meetings where they could express their views about the home and their care.

A range of activities were provided both in-house and in the community. People were able to choose where they spent their time.

The management team investigated and responded to people’s complaints, according to the provider’s complaints procedure. People we spoke with did not raise any complaints or concerns about living at the home.

There were effective systems in place to monitor and improve the quality of the service provided. We saw copies of reports produced by the management team.

We found the home was in breach of one of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

The people who used the service were being supported and enabled to make informed choices about their programme of rehabilitation.

One person who was living in the unit at the time of our inspection told us they liked living there and preferred it to the main house.

We saw that comprehensive assessments were carried out prior to admission and on admission to Daniel Yorath House.

People said staff promoted their independence, and prepared them for their rehabilitation programme.

People who used the service told us they had given consent to their care and treatment.

We saw that staff did not keep people waiting when asked for support. This meant staff were respectful towards people who used the service.

We saw that policies and procedures were in place in relation to receiving, administering and storing medication. This meant people were protected because the service provided instructions so that staff handled medication safely.

We saw evidence that demonstrated staff were provided with regular formal supervision. Staff told us that they were supported by management who enabled and encouraged them to access appropriate training on a regular basis.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. The quality of the service was monitored through monthly internal audits and included monthly service user feedback questionnaires.

We spoke to the service users living in the unit and they told us they were happy to be there. They told us that they felt safe and enjoyed living there. They told us that they liked the staff and felt they were treated well.

We saw that a comprehensive assessment had been carried out after the service users had been admitted to the main unit, Daniel Yorath House. Transfer to this unit had been identified as part of their care plan.

The service users we spoke to knew how to raise any concerns they may have. They felt that staff would listen to what they had to say and felt involved in planning their care and treatment.

We saw that service users were treated with respect by the staff. Staff told us that they enjoyed working at the unit because they could see the change in people. Staff told us that they felt supported by management and that the training they received was good. We saw evidence that staff received regular supervision and had annual personal development plans in place.

The quality of the service is monitored through monthly internal audits and includes monthly service user feedback questionnaires. We saw that there was a service user meeting each month and this was well attended. The service user we spoke to told us that staff would ask him to be involved in developing their care plan and in any reviews of care and treatment.