Background to this inspection
Updated
11 December 2020
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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.
The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.
This inspection took place on 16 November and was announced.
Updated
11 December 2020
About the service
The Dean Neurological Care Centre is a care home providing personal and nursing care to adults with complex and life changing neurological disorders. 44 people were in receipt of care at the time of the inspection. The service can accommodate up to 60 people.
The home was purpose built and people received care and therapy support in one adapted building. Each person had their own bedroom with washing and toilet facilities; they shared spacious communal areas. Outside there was an easily accessible decking area.
People’s experience of using this service and what we found
People told us they felt more settled than when we last inspected. They were aware there had been changes in the management of the service and they spoke with us about the improvements they were aware of. People were generally happy with their care and had opportunities to discuss with staff areas they wanted altered.
Following our previous inspection, the provider had appointed an interim management team to drive their improvement plan and improve standards. We found the provider had effectively implemented their improvement plan and the improvements they had reported on every month were evident.
New and permanent home managers had recently been employed and time was needed for the new management team to get to know the service and to ensure all the planned improvements were completed.
Staff morale had improved, and staff spoke positively about working at the service.
Engagement with people and relatives was meaningful and extensive. Regular Residents Forums and surveys took place and we found lessons had been learned from complaints and incidents.
People felt safe and able to talk with senior staff if they needed to. Staff knew what action to take to maintain people’s safety. Security measures were in place to keep people safe.
Risks to people’s health, safety and the environment were assessed, monitored well and action taken to reduce these.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
People had access to medical and emergency support when needed. People’s medicines were managed safely.
People’s complex care and treatment was reviewed regularly by specialist healthcare professionals. Visiting professionals told us the service had improved how it communicated with them about people’s conditions and needs.
Some improvements had been made to people’s care and treatment records. Professionals told us they had noticed this and could more easily find the information they required when they visited. Managers told us further improvements to people’s records were planned.
Staff training, and support had improved, and they were supported to provide safe care and treatment to people which was in line with best practice guidance.
Staff had access to the information they required about people’s care and therapy needs. Guidance for staff was now provided in a way which supported a person-centred approach to care.
People’s care and therapy was reviewed regularly with them and their views and choices on this incorporated into the planning of their care.
Staff described a “wholesale change” in how care and therapy staff worked. A more collaborative way of working had been adopted and people had benefited from this.
Staff showed warmth and compassion towards people and were concerned for people when they were distressed or poorly. There was a genuine desire for people to live as well as they could and as comfortably as they could.
People were supported with activities they enjoyed, and, despite people’s complex conditions and personal preferences, a great effort was made by staff to make these fully inclusive of everyone.
We observed staff interacting positively with people. People looked relaxed in the staffs’ company. This demonstrated that important, supportive and meaningful relationships had been built between people and those who cared for them.
There were no restrictions on visiting and one person told us their dog was able to visit them.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was Requires Improvement (report 5 July 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating and to follow action we had told the provider to take following the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Dean Neurological Centre on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.