Background to this inspection
Updated
25 December 2021
The inspection
This was a targeted inspection to check on a specific concern we had about the COVID-19 vaccination status of staff working at the service
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
This inspection was conducted by one inspector.
Service and service type
Gardens Neurological Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. 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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection-
We spoke with five members of staff including the clinical manager, registered manager and senior management from the provider organisation.
We reviewed a range of records. This included staff training records, rotas, schedules and audits. We also looked at a variety of records relating to the management of the service, including policies and procedures.
Updated
25 December 2021
The inspection took place on 12 June 2018 and was unannounced.
Gardens Neurological Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. They are registered to provide accommodation and treatment for up to 54 people, aged 18 years or older, with complex long term neurological conditions, brain or spinal injuries.
Gardens Neurological Centre is owned and operated by Ramsay Health Care UK Operations Limited, which is a subsidiary of Ramsay Health Care (UK) Limited. The centre provides nursing care, personal care, medical treatment and diagnostic procedures in a purpose-built environment over two floors. The staff at the centre assists people’s recovery wherever possible and specialise in slow stream rehabilitation. Some people had lived there for many years and others were more recent admissions working towards returning to their own homes. There were 51 people accommodated at the home at the time of this inspection.
At our last inspection 24 May 2017 we found that the provider did not take appropriate actions to ensure that people’s safety and welfare was promoted and protected and they were in breach of Regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2014. We also found that the providers quality assurance systems had not identified potential risks to people's safety and wellbeing and they were in breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014. We rated the service Requires Improvement.
At this inspection, we found that sufficient improvements were made to support the rating of Good. Following the inspection on 24 May 2017 the provider submitted an action plan to us to detail how they were going to address the concerns we found. We found that they have completed the actions they told us they were going to do.
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff understood their responsibilities in relation to safeguarding. Training and systems in place supported this. While records had some gaps, staff knew how to support people safely in line with their individual assessed risks. Observations demonstrated that there were enough staff available to meet people's needs safely and well. Staff confirmed their competency in medicines was routinely assessed to ensure safe practice. No concerns in relation to prevention and control of infection were identified. Staff confirmed their understanding of their responsibility in reporting and recording accidents and incidents. We saw that lessons were learned after incidents and additional control measures were discussed to minimise the risk of reoccurrence.
People's needs were assessed and information about their diverse needs was recorded. People were supported by staff who were provided with opportunities for training, skills development and ongoing assessment of their competence. People had choices in relation to food and drink and were encouraged to have good nutrition and fluid intake. People’s specific dietary needs in relation to their culture and lifestyle preferences were recognised and provided for. People were involved in decisions regarding the environment of their personal space. The premises offered some challenges in terms of space and decor was tired in places. Staff had received training in and understood the impact of Mental Capacity Act 2005 and Deprivation of Liberty Safeguards for people living in the service. Observation showed that staff sought people's consent for everyday decisions.
People were supported by kind and caring staff. People knew staff by name and were aware who their key worker was. The staff group was from a wide range of different backgrounds and in some cases, were able to speak with people or their relatives where English was not their first language. Staff were knowledgeable about the needs and backgrounds of the people they supported. Visitors were welcomed in the service and people's relationships respected. People's privacy and dignity was appreciated and their independence was promoted in a positive way. People told us and records showed that people had been involved in the planning of their care.
People were supported by a range of professionally qualified staff employed by the provider. There was a permanent GP at the home supporting people`s health needs on a daily basis. A team consisting of physiotherapists, occupational health therapist and nursing staff ensured people`s needs were met effectively. People's care and support needs were planned for and reviewed weekly through multi-disciplinary meetings. The care records could have been clearer in some areas, however, when we shared this with staff, they confirmed they would address this. No evidence was found to indicate that this had had any impact on people's well-being.
The service was developing their approach to end of life care planning by providing training for staff and including relatives as well as people where possible in discussions around their preferences and wishes when people were nearing the end of their life.
People told us staff encouraged them to be involved in their care and retain or regain their independence as much as possible. People were provided with opportunities to engage in social activities of interest to them.
The service has established leadership with a clear chain of command. This helped staff to understand their roles and responsibilities and those of others. The service was effectively organised and well run with an open and transparent culture. The registered manager was supported by a dynamic well -developed management structure and the management team demonstrated a holistic approach and had clear oversight of how the service was meeting people’s physical, emotional and social needs.
The service actively encouraged and provided a range of opportunities for people who used the service and their relatives to provide feedback and comment upon the service in order to continue to drive improvement. There was a comprehensive auditing programme carried out by the management team and the provider. Action plans were comprehensive in detailing actions taken, time frames and the responsible person for the actions taken.