Archived: Sue Ryder - Holme Hall

Updated 30 March 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 30 January 2017 and it was unannounced. The inspection team consisted of one adult social care inspector 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. The expert-by-experience who assisted with this inspection had knowledge and experience relating to people with physical disabilities.

Before the inspection we spoke with the local authority safeguarding and commissioning teams to gain their views of the service. We reviewed all of the information we held about the service, including notifications, inspection reports and actions plans sent to us by the registered provider which outlined the actions they would take regarding the breaches identified at the previous inspection. The registered provider submitted a provider information return (PIR) in January 2017 within the given timescales for return. The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with the support services manager, the chief nurse for Sue Ryder national care services, the nursing lead for the service, the manager, two physiotherapy clinicians, the training administrator and five members of staff. People who used the service had complex neurological and often associated physical impairment which meant we were not able to hold significant discussions with them on their experience of the service. We exchanged pleasantries with some individuals and carried out observations during the inspection in the communal areas and during mealtimes. These observations helped us to understand the experience of people who could not communicate with us. We spoke with one relative face-to-face and telephoned two others to obtain their perceptions of the service.

We looked at two people’s care records, including their initial assessments, care plans, reviews, risk assessments and Medication Administration Records (MARs). We looked at how the service used the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure that when people were assessed as lacking capacity to make informed decisions themselves or when they were deprived of their liberty, actions were taken in their best interest.

We also looked at a selection of documentation pertaining to the management and running of the service. This included quality assurance information, audits, stakeholder surveys, recruitment information for five members of staff, staff training records, policies and procedures and records of maintenance carried out on equipment.

Updated 30 March 2017

This inspection took place on 30 January 2017 and was unannounced. The inspection was to check that the registered provider was now meeting breaches of legal requirements we had identified at the last inspection on 9 November 2015. We asked the registered provider to take action to improve: Regulation 12: Safe care and treatment and Regulation 18: Staffing.

During this inspection we found that the registered provider had taken action to improve practices within the service in line with their action plan from March 2016. We found these improvements were sufficient to meet the requirements of Regulation 12 and 18. This meant the service had met the breaches of regulation imposed at the previous inspection.

Sue Ryder - Holme Hall is registered to provide care and support including nursing care for up to 40 people over the age of 18 years old with a range of neurological conditions including Brain Injury, Multiple Sclerosis, Huntington's Disease, Cerebral Palsy, Stroke and Parkinson's Disease. The service is located in Holme-on-Spalding-Moor in the East Riding of Yorkshire. At the time of this inspection there were 24 people using the service.

The service has three floors. The ground floor is used for communal space and administration, Blue floor is the first upstairs level and accommodates people with complex neurological conditions and Green floor is the second upstairs level and accommodates people who are more independent.

The registered provider is required to have a registered manager in post and at the time of our inspection the manager’s application to register was being processed by the Care Quality Commission (CQC). 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.

We found that the care staff had a good knowledge of how to keep people safe from harm and the staff had been employed following robust recruitment and selection processes.

We found that improvements had been made to the safe management of medicines. People received their medicines on time and as prescribed by their GP. The recording and administration of medicines was much better than at our previous visit and medicines were stored safely and disposed of appropriately.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include preferences, likes and dislikes. People who used the service received additional care and treatment from health professionals based in the community. People had risk assessments in their care files to help minimise risks whilst still supporting people to make choices and decisions.

Improvements had been made to the frequency of staff supervisions and the number of staff attending training sessions. People who used the service were cared for and supported by qualified and competent staff that were regularly supervised and received appraisal regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.

People received adequate nutrition and hydration to maintain their levels of health and wellbeing.

People had been included in planning menus and their feedback about the meals in the service had been listened to and acted on.

People were able to see their families as they wanted. There were no restrictions on when people could visit the service. We saw that staff were caring and people were happy with the care they received. People had access to community facilities and most participated in the activities provided in the service.

We observed good interactions between people who lived in the service and staff on the day of the inspection. We found that people received compassionate care from kind staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.

People’s comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. We saw that the manager met with people on a regular basis to discuss their care and any concerns they might have. This meant people were consulted about their care and treatment and were able to make their own choices and decisions.

People’s wellbeing, privacy, dignity and independence were monitored and respected and staff worked to maintain these wherever possible.

The staff told us that the service was well managed. The manager monitored the quality of the service, supported the members of staff and ensured that there were effective communication and response systems in place for people who used the service.