Archived: Middlesbrough Intermediate Care Centre

Updated 4 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 7 and 8 February 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because we were also inspecting another location operated by the provider at the same time and needed to make sure the registered manager was present.

The inspection team consisted of one adult social care inspector and one expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. This ExE had experience of working with older people and intermediate care services.

We had requested a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.

Before commencing the inspection we looked at the information we held about the service. This included any notifications that had been received, any complaints, whistleblowing or safeguarding information. A notification is information about important events which the service is required to send us by law. We also contacted health and social care professionals prior to the inspection to gather their views about the service. We also spoke with an infection control nurse and training provider who were visiting the service during our inspection.

During the inspection we reviewed a range of records. This included three people’s care records and medicines records. We also looked at three staff recruitment files, including supervision, appraisal and training records, records relating to the management of the service and a wide variety of policies and procedures. We spoke with seven people who used the service and three relatives. Time was spent observing people in the communal areas of the service and at lunch time.

We spoke with the registered manager, senior team lead, two team leaders, the cook, a therapy assistant, the head of service for prevention, access and provider services, an occupational therapist and generally to other staff.

Updated 4 April 2018

Middlesbrough Intermediate Care Centre (MICC) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service provides short term rehabilitation to maximise the independence of people and enable them to return to living in their own home. The service comprises of care and therapy (occupational therapy and physiotherapy) all based in the same building and provides a range of facilities and equipment for up to 23 people who require rehabilitation. At the time of our inspection 13 people were using the service.

At our last inspection we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place.

Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies, around administering medication, were regularly checked. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

People and relatives told us there were suitable numbers of staff on duty to ensure people’s needs were met.

Pre-employment checks were made to reduce the likelihood of employing staff who were unsuitable to work with people.

The registered manager had systems in place for reporting, recording, and monitoring significant events, incidents and accidents. The registered manager told us that lessons were learnt when they reviewed complaints and any accidents and incidents to determine any themes or trends.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place and staff were suitably trained and received all the support they needed to perform their roles.

People were supported with eating and drinking and feedback about the quality of meals was positive. Some people were also supported with meal preparation. Special diets were catered for, and alternative choices were offered to people if they did not like any of the menu choices. Nutritional assessments were carried out and action was taken if people were at risk of malnutrition.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The premises were clean and tidy. However, some areas were in need of redecoration and replacement flooring.

We observed numerous examples when staff were kind, caring and courteous. Privacy and dignity of people was promoted and maintained by staff. Explanations and reassurance was provided to people throughout the day.

Care plans detailed people’s needs and preferences. Care plans were reviewed on a regular basis to ensure they contained up to date information.

The service had a clear process for handling complaints.

The registered manager was aware of the Accessible Information Standard that was introduced in 2016. The Accessible Information Standard is a law which aims to make sure people with a disability or sensory loss are given information they can understand, and the communication support they need. The registered manager told us they provided and accessed information for people that was understandable to them. They told us their service user’s guide and other information was available in different formats and fonts.

Staff told us they enjoyed working at the service and felt supported by the registered manager and senior staff. Quality assurance processes were in place to monitor and improve the quality of the service. However, we did note a three month gap where the health and safety audit had not been undertaken and the medicine audit did not pick up that the room in which medicines were stored was on occasions too high. We pointed this out to the registered manager who was to take action to address this.