Royal Hospital for Neuro-Disability

Updated 7 September 2023

The Royal Hospital for Neuro-Disability (RHN) is an independent medical charity which provides neurological services to the entire adult population of England. The hospital specialises in the care and management of adults with a wide range of neurological problems (including those with highly dependent and complex care needs), people in a minimally aware state, people with challenging behaviour, and people needing invasive and non-invasive mechanical ventilation.

The RHN is registered to provide diagnostic and screening activities, treatment of disease, disorder or injury, accommodation for people needing nursing or personal care and transport, triage and medical advice provided remotely.

The service was last inspected in September 2021. This was a focused inspection where we inspected the safe and well-led domains to ensure improvement had been seen following the inspection undertaken in February 2020. The service had improved and was re-rated good overall, with good in safe, effective, caring, responsive and well-led.

The RHN has a total of 237 beds across 12 wards, which are arranged into five service lines; a brain injury service, continuing care service, specialist respiratory services, a specialist behavioural service, and a young adult service. The hospital provides specialist care to patients with a wide range of severe brain injuries, a range of complex neurological disabilities caused by damage to the brain or other parts of the nervous system as a result of brain haemorrhage, traffic accidents or progressive neurological conditions.

Updated 7 September 2023

Our rating of this service went down. We rated it as requires improvement because:

• The service did not always ensure that medicines were managed in a safe way. We found expired medications available for use in ward areas, unsafe storage and use of medical gases, unsupervised dispensing of medications by untrained staff, and an out-of-date medicines management policy.
• The service did not have effective governance systems in place to ensure that actions were taken in response to national patient safety alerts. National Patient Safety Alerts (NatPSAs) are official notices from NHS England giving instructions to providers on how to prevent risks which might cause serious harm or death. We found the service had not taken all actions required from a medical gases alert issued in June 2021, meaning patients remained at risk of serious harm or death.
• The service did not always ensure that all equipment was clean and ready for use, or labelled to show when it had been cleaned.
• The service did not always ensure that equipment used for obtaining laboratory specimens were within their expiration date.
• Leaders did not always have clear oversight of the risks to their patients.

However

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well.
• The service controlled infection risk well. Staff assessed risks to patients, acted on them, and kept good care records.
• The service managed safety incidents well and learned lessons from them.
• Leaders supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work.
• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.
• The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

Updated 7 September 2023

See overall summary above

Updated 15 July 2020

We rated Safe and Well Led as Requires Improvement, with Effective, Caring and Responsive rated as Good. This led to an overall rating of Requires Improvement.