Archived: Hunters Moor Neurorehabilitation Centre for the West Midlands - The Olive Carter Unit

Updated 31 July 2020

The Olive Carter Unit is part of Hunters Moor Residential Services Limited and is located in a residential area of Birmingham. The unit specialises in neurobehavioral rehabilitation for men and women over the age of 18 years with a primary diagnosis of acquired brain injury. This includes those whose rights are restricted under the Mental Health Act 1983 and Mental Capacity Act.

The unit provides services for up to ten patients and as a specialist challenging behaviour unit, patients come from a wide geographical area. Commissioners where patients ordinarily reside commission the service. The unit has been registered with the Care Quality Commission since 11 January 2011 to carry out the following regulated activities.

• Treatment of disease disorder or injury
• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Diagnostic and screening procedures

The last comprehensive inspection was on the 17 and 18 September 2019. We told the provider it must make improvements to:

• ensure regular reviews of medicines are carried out and outcomes are recorded.

• ensure that all risk assessments are regularly updated. A copy of the risk assessment should be provided for family members and carers to support section 17 leave.

• ensure the true maximum and minimum temperatures of the refrigerator are measured and recorded daily to ensure medicines remain effective in treating the conditions they were prescribed for.
• ensure staff do not use unauthorised seclusion for patients in any area of the ward Unauthorised seclusion happens when a patient is forcibly confined to a room or space without staff having the legal right to confine them.
• provide Mental Health Act training as part of the mandatory training for all staff.
• ensure that the lift is replaced.
• ensure that all fire doors operate effectively.

The inspection was undertaken to follow up on specific issues so we did not review what progress the provider had made with the above required improvements. We will follow this up in due course.

Updated 31 July 2020

We rated The Olive Carter Unit as requires improvement overall because:

• Fire doors at the service did not have door closures as they were highlighted as a risk to patients and removed by the service. They had not been replaced in a timely manner; this left patients at risk in the event of a fire. We saw that two of the communal toilets within the ward were visibly soiled.

• Although staff had training on percutaneous endoscopic gastrostomy (PEG) feeding there were no protocols in place to support staff when completing the task.

• We saw during our inspection, a patient taken to their room and staff prevented them from leaving by holding on to the door handle. This was contrary to the training provided by the service. There was no specific care plan to support this type of seclusion.

• Mental Health Act training did not form part of the service mandatory training. Staff were provided with ongoing training from consultant psychiatrists on specific staff training days. Staff signed a record of attendance to provide the service with completion rates.

• Risk assessments were not always updated.

• The lift needed to be replaced and was not in use at the time of the inspection. The manager informed us that the service had developed a plan to replace the lift.

• Staff did not always record fridge temperatures accurately.

However;

• The ward was well equipped, well-furnished and fit for purpose. The service had enough nursing and medical staff, who knew the patients and received basic training to keep patients safe from avoidable harm.

• The ward had a good track record on safety. The service managed patient safety incidents well. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support.

• Staff assessed the physical and mental health of all patients on admission. They developed individual care plans, which they reviewed regularly through multidisciplinary discussion. Care plans reflected the assessed needs, were personalised, holistic and recovery oriented.

• Staff provided a range of care and treatment interventions suitable for the patient group and consistent with national guidance on best practice. This included access to support for self-care and the development of everyday living skills. Staff ensured that patients had good access to physical healthcare and supported patients to live healthier lives.

• Managers made sure they had staff with a range of skills needed to provide high quality care. They supported staff with appraisals, supervision and opportunities to update and further develop their skills. Managers provided an induction programme for new staff.

• Staff treated patients with compassion and kindness. They understood the individual needs of patients and supported patients to understand and manage their care, treatment or condition.

• The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with the whole team.

Updated 12 May 2020