Neurological Centre - Lancashire

Updated 5 January 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and specialist professional advisor who specialised in physiotherapy practices.

Service and service type

Sue Ryder Neurological Care Centre (Lancashire) is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with nine people across the service, we asked them about their experience of the care provided. We spoke with the registered manager, the operations director, clinical lead and therapist lead. We spoke with 11 staff and two visiting relatives.

We reviewed a range of records. This included seven people’s care records, multiple medication records and accident and incident records. We looked at a variety of records related to the management and maintenance of the service and walked around the buildings to make sure the environment was clean and safe for people to live in.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted health and social care professionals from the local authority who visited the service.

Updated 5 January 2022

About the service

Sue Ryder Neurological Care Centre (Lancashire) is a care home providing specialist neurological care and rehabilitation to people aged 18 and over with complex neurological needs, such as multiple sclerosis, acquired brain injury, cerebral palsy, Parkinson's disease, Huntington's disease and motor neurone disease. Care is provided across three floors. One of the floors specialises in providing care for people requiring neurological rehabilitation. Rehabilitation services are provided on a short term basis to support people to regain their abilities after a hospital stay and regain independence. There were 38 people living at the service at the time of the inspection.

People’s experience of using this service and what we found

People told us they received safe care and treatment and measures were in place to monitor risks around people including falls, choking and infections. People were supported to receive their medicines safely, however, there were areas that needed to be improved to enhance the safety of medicines practices.

We have made a recommendation about the management of some medicines.

Staff were committed to enabling people to do as much for themselves as possible and took a positive risk-taking approach to care. Staff knew how to keep people safe and the service learned from near misses, accidents and incidents and used this learning to improve the service. Improvements were required to ensure incidents that required to be reported to other agencies were always reported. We have made a recommendation about reporting incidents to safeguarding. Staff were recruited in a safe way and there were enough staff to meet the needs of each person.

The service was well-led. The registered manager and the management team provided a positive model for all the staff. Feedback about the registered manager was positive and staff felt well supported. Staff were motivated and proud of the service, and morale was high. Systems for monitoring the quality of care and people’s experiences were in place and there was a proactive approach to monitoring. While there was oversight on the system for monitoring incidents, we noted improvements were needed to the system for checking incidents and reporting to external agencies.

We made a recommendation about improving the monitoring and reporting incidents.

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 and professionals’ feedback about the effectiveness of the service describes it as exceptional and distinctive. Staff skills knowledge, training and support demonstrated an excellent commitment to providing outstanding care which was embedded into the practices of the staff and the management team. The service worked in partnership with other organisations and keeps up to date with new research and development to make sure staff were trained to follow best practice and contributed to the development of best practice and good leadership with others. The provider recognised that continuing development of skills, competence and knowledge for staff was integral to ensuring high-quality care and support. We found that this directly impacted positively on people’s outcomes. People received a balanced diet which met their individual needs and took into consideration their preferences. There was a holistic approach to assessing, planning and delivering care and support.

People told us they received safe care and treatment and measures were in place to monitor risks around people including falls, choking and infections. People were supported to receive their medicines safely, however, there were areas that needed to be improved to enhance the safety of medicines practices.

We have made a recommendation about the management of some medicines.

Staff were committed to enabling people to do as much for themselves as possible and took a positive risk-taking approach to care. Staff knew how to keep people safe and the service learned from near misses, accidents and incidents and used this learning to improve the service. Improvements were required to the system for recording and reporting incidents externally. We have made a recommendation about reporting incidents to safeguarding. Staff were recruited in a safe way and there were enough staff to meet the needs of each person.

People were supported by staff who were kind and caring and who maintained their dignity and privacy and treated them with respect. People were fully involved in the service and had opportunities to give feedback about their experiences. People's needs, and wishes were fully met by staff that knew them well and were passionate about people’s independence. People were respected and valued as individuals. people’s comments included, “I do believe staff cannot do enough for me, I only have to ask.”

People received personalised care and support specific to their needs and preferences. Care records were written in a person-centred manner and reviewed regularly. This had been effective in supporting people to achieve their goals and aspirations and encouraged more freedom for people. People’s communication needs were assessed, and staff used various tools to assist people with communication needs. People and their relatives were able to share concerns and compliments.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 16 April 2020 and this is the first inspection of this new location. The last rating for the service at the previous premises was good, published on 12 March 2018.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.