Inspire Neurocare Worcester

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last inspection we rated this key requires improvement. At this assessment the provider had made improvements, and the rating has changed to good. Staff demonstrated good knowledge of people and their support needs and had made improvements with following people person centred care plans. For example, oral care guidance had improved, and staff had received training to ensure people received appropriate oral care hygiene.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most people and relatives told us they were involved in care planning and regular reviews. One person told us they had recently spent an afternoon with a member of staff reviewing their care plan and they were keen to continue this on a regular basis. One relative told us, “We are invited to come in if there is anything they are wanting to change. They ask my opinion”.

Staff were knowledgeable about people’s assessed needs and were able to tell us when people required more specialised care. For example, a person who was currently completing a rehabilitation programme had had regular reviews to assess and review their support needs whilst accessing the community.

People had detailed care plans and risk assessments, and their care needs had been regularly reviewed. Where people required additional support and monitoring, external agencies had been referred to for more comprehensive treatment. For example, dieticians for nutrition and hydration support, and Access to Communication and Technology services (ACT) where people had been reviewed for communication aids.

The service planned and delivered people’s care and treatment with them, including what is important and matters to them. They did this in line with legislation and current evidence-based good practice and standards. People’s nutritional needs were met. One person told us they were a vegetarian and enjoyed spicy food and the chef caters for their specific tastes. Relatives told us they were welcomed to stay for lunch during their visits. One relative told us, “The food is excellent - food is well presented even for people on puree diets”. Relatives visited the home to join their loved ones for themed events.

Staff had received training and demonstrated good knowledge on people’s specific nutritional and hydration needs and worked in conjunction with external professionals for additional advice, For example, dieticians.

People had person centred care plans and risk assessments for their specific needs which were reviewed regularly. Where people had complex nutritional needs, their views and their relative’s views had been sought through regular meetings. Staff used nationally recognised tools appropriately to assess and monitor people’s needs. For example, the Malnutrition Universal Screening Tool (MUST) was used to identify people from risk of malnutrition.

People and relatives told us they had access to external professionals where required. Such as, dentists, GP’s chiropodists and Parkinsons’s nurses.

Staff and leaders worked effectively both alongside the in-house therapy team and external professionals to ensure people’s identified needs were risk assessed and reviewed safely. For example, where people had moved into the service staff had liaised with their previous providers or placements to gather information to ensure a safe and effective transition.

Professionals told us the service worked well with them, one professional told us, , “They have an understanding of my role and the need to keep me up to date with any changes to my client or their needs”.

People had detailed care plans in place which incorporated clinical guidance and regular reviews. Where people were looking to transition into more independent services after a period of neurorehabilitation, the provider had worked alongside families and external professionals. The provider held daily meetings for their leaders and staff received daily handovers.

People and relatives told us the service had made improvements when supporting their complex health needs. On relative told us, “They are more mindful of their needs now. The therapy team are good and very supportive. It was noticeable when the team started recovering”.

Management at the service knew people’s needs well and this was documented in care records. Leaders met daily to discuss any changes. People’s health was promoted by good nutrition and hydration. Staff had received training and demonstrated good knowledge of people’s modified diet needs and worked closely with the in-house speech and language therapist to ensure good communication when people’s needs changed.

Care records demonstrated where people required healthcare monitoring and visits from external professionals. For example, Bowel and bladder clinic referrals, GPs, specialist nurse’s, dieticians, dentists and chiropodists. The service had regular visits from an ANP which provided continuity for people.

People told us there had been improvements with the availability of both internal and external activities and therapy choices. People and families felt more involved with the running of the service.

Staff told us they felt more positively about improving outcomes for people. One staff member told us, “The role is now more relaxed, we focus on the day to day, achieving our goals, we have time to complete our checks thoroughly. Staff have more incentive on doing things alone, they want to do more with people, and they get enjoyment out of it”.

The provider had implemented effective approaches to monitoring people’s care and treatment. Where concerns were identified, advice, mitigation and reviews could take place without delays.

People and relatives understood their rights around care and treatment. We observed staff knocking on doors and asking people’s permission before carrying out tasks. One relative told us, “The nurses say, “I have got your meds are you ok”. They will wait for them to put their hand up before they start”.

Staff shared a good understanding of how to assess people’s consent to care and treatment. Where people had required reviews of their capacity to make decisions about their care and treatment, the relevant internal and external representatives had attended, alongside the person and their representatives.

The provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty (DOLS). There was evidence referrals had been made to the local authority and where conditions had been authorised, these were detailed in people’s care plans. The provider used a tracker to have oversight of when people’s assessments needed reviewing.