Stocksbridge Neuro Rehabilitation Centre

Updated 8 July 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Stocksbridge Neuro Rehabilitation Centre 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. Stocksbridge Neuro Rehabilitation Centre 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 CQC 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 not a registered manager in post. A new manager had been in post for 4 months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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 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 all this information to plan our inspection.

During the inspection

We spoke with 2 people and 7 relatives about their experience and views of the service. We spoke with 9 staff including, the regional manager, the manager, the deputy manager, care staff, nursing staff, and members of the domestic staff team. We carried out observations of care. We reviewed a range of records. These included 3 people's care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures. We also spoke with a professional who worked regularly with the service.

Updated 8 July 2023

About the service

Stocksbridge Neuro Rehabilitation Centre is a care home providing personal and nursing care to up to 24 people. The service provides support to people who have a brain injury and require rehabilitation. At the time of our inspection there were 12 people using the service.

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

People, staff, and relatives told us more staff were needed and staff were rushed when completing tasks. The provider had not completed a dependency tool to determine staffing levels. Whilst improvements were made in relation to staff training and competencies, further improvement was needed to ensure staff completed all training relevant to their roles.

Risk assessments were in place for people and detailed how to keep them safe. However, staff did not always complete care records, to evidence that people received their care in line with their assessed needs. For example, where people required support with repositioning, catheter care and tracheostomy care, daily records did not always contain information that this was carried out at the specified times. Accidents and incidents were recorded and monitored by the management team. However, improvements were required to ensure all incidents were monitored, with lessons learned from them.

Whilst new systems were implemented to ensure overarching governance was in place, these had not identified all concerns found on the inspection. Staff told us they did not feel supported by the manager and some relatives told us communication was poor. We found the service worked closely with external professionals and this formed part of people’s care planning. However, some relatives told us there had been delays in accessing healthcare appointments for their loved ones.

The manager was new to the service and had introduced some new systems and processes which had improved the overall organisation of how the service was working. The manager had recognised shortfalls and a service development plan was ongoing to drive improvements.

Staff were recruited safely, and people told us staff were kind and caring. Medicines were safely managed, and people received their medicines as prescribed. Staff understood their roles in relation to safeguarding people from the risk of abuse and the manager reported notifiable incidents to external agencies as required.

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.

For more details, please see the full report which is on the Care Quality Commission's (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 28 July 2022). 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 the provider remained in breach of regulations.

At our last inspection we recommended that the provider reviews their systems in regards to the deployment of staff. At this inspection we found improvement was still required.

The last rating for this service was requires improvement. The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stocksbridge Neuro Rehabilitation Centre on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risks, staffing and governance.

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.