Background to this inspection
Updated
29 September 2023
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 Health and Social Care Act 2008.
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 team consisted of 4 inspectors.
Service and service type
Hunter’s Moor is a ‘care home’. People in care homes receive accommodation and nursing and or personal care as a single package under one contractual agreement dependent on their registration with us. Hunter’s Moor is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
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 and sought feedback from the local Integrated Care Board (ICB) who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 8 people who used the service and 4 relatives about their experience of the care provided. We spoke with 20 members of staff including the registered manager, ward manager, doctor, speech and language therapist, chef, domestic and care staff. We carried out general observations of the way people were supported.
We reviewed a range of records, including 5 people’s care records. We looked at 3 staff files in relation to recruitment and staff support and a range of records relating to how the service operated and was managed.
Updated
29 September 2023
About the service
Hunters Moor Neurorehabilitation Centre provides personal and nursing care for up to 42 people. The service provides support to people with neurological conditions, brain injuries and complex physical rehabilitation needs. At the time of our inspection 24 people were using the service and 1 person was in hospital.
People’s experience of using this service and what we found
Quality assurance systems and checks to monitor the service and drive improvements were not always effective and robust enough to provide effective oversight of the service. Audits had failed to identify the issues we found, for example around infection prevention and control.
People received their medicines when they needed them, however improvement was needed to ensure all medicines administered via a patch were applied safely. The ward manager took immediate action to address this.
The management of risks associated with people’s care had improved but further improvement was needed to ensure detailed entries were made in all care records, to accurately reflect the care people received. Staff were recruited safely and understood their responsibilities to keep people safe.
Mixed views were shared with us about the choice of meals available, and some people told us their cultural and dietary needs were not always met. People had access to a range of health professionals which supported their health and wellbeing.
More needed to be done to ensure people consistently felt their privacy and dignity were protected.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People received responsive care and support tailored to their rehabilitation and wellbeing. People and relatives knew how to make a complaint, and complaints received had been resolved in line with the provider’s policy.
Several changes to the management team had occurred since our last inspection, they welcomed our feedback and demonstrated a commitment to improving outcomes for people.
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 (published 25 May 2022) and there were breaches of regulation. The provider received 2 warning notices following the last inspection. The provider was required to send us an action plan telling us how they would improve and by when. At this inspection not enough improvement had been made and the provider was still in breach of regulation 17 (Good Governance).
The overall rating for the service has remained requires improvement. This service has been rated as requires improvement for the last 2 consecutive inspections.
Why we inspected
This inspection was prompted due to concerns received in relation to the quality of care and the safety of people using the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well led only. This inspection also checked if the provider had followed their action plan to meet legal requirements.
We inspected and found there was a concern with people’s dignity and privacy not always being respected, so we widened the scope of the inspection to a comprehensive inspection which included the key questions responsive and caring.
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.
We found evidence that the provider needs to make improvements. Please see the safe, effective, caring, and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hunters Moor Neurorehabilitation Centre on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified a breach in relation to the governance of the service. We found the provider failed to meet all of the warning notice we issued at the last inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.