Archived: Sue Ryder - Cuerden Hall

Updated 13 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the 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.

The inspection took place on the 12 February January 2018, and was completed by 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 at this inspection had experience of working with and caring for older people with dementia and neurological impairments.

Prior to the inspection we gathered the available information from Care Quality Commission (CQC) systems to help plan the inspection. This included the detail of any notifications received, any safeguarding alerts made to the Local Authority, any complaints or whistle-blowing information received and the detail of the Provider Information Return (PIR) received from the provider. The PIR is submitted to the CQC by the provider and includes details of the provider’s perspective on meeting the requirements of the regulations.

We spoke with nine people who used the service, three visiting relatives, and two visiting professionals, 11 members of staff, the registered manager, head of care services and head of nursing care. During the inspection we reviewed four people’s care plans, four staff files, quality audits, team meeting notes, medication records and other documents and records associated with the running the of service.

Updated 13 March 2018

Sue Ryder Cuerden Hall 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.

With 38 beds and countryside views, the service provides care and support to people aged 18 and over with complex neurological needs, such as multiple sclerosis, acquired brain injury, cerebral palsy, Parkinson's disease, Huntington's disease and motor neurone disease. A number of the people at the home have lived there for a number of years.

This inspection took place on 12 February 2018, and was unannounced.

At the last inspection on 21 July 2016 we found that the service was in breach of Regulation 12: Safe care and treatment, as the provider did not have suitable arrangements in place to make sure that care and treatment was provided in a safe way for service users.

We also found a breach in Regulation 18 Staffing: the provider did not ensure that sufficient numbers of suitably qualified, competent, skilled and experienced persons were deployed in order to meet the requirements of the regulation. The service was given the rating: Requires Improvement.

At this inspection, we found that the service was no longer in breach of the Regulations, and that no further breaches were found. The service has been given the rating: Good.

Staffing levels and the deployment of staff were now assessed, monitored and reviewed on a weekly basis against the assessed needs of the people living at the home. Risk assessments and risk management strategies were now in pace for all people living at the home. These were regularly reviewed, and if changes were needed then these were swiftly implemented in order to ensure people’s safety was promoted and protected.

We found that the registered manager had acted on our recommendations made at the previous inspection in 2016. We found that the principles of the Mental Capacity Act (MCA) were now embedded in practice within the home, and all the relevant documentation is now completed in line the MCA. People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice.

Changes in people’s needs were now recorded in a timely manner and any involvement by external professionals involved in people’s care was clearly recorded. Quality assurance processes now ensured that any risks or shortfalls in care were identified and deal with in a timely fashion.

A registered manager was in post at the service. A registered manager is a person who has registered with the Care Quality Commission 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.

The registered manager and management team were passionate about ensuring people at the service had a good quality of life and were supported safely. They worked well with outside professionals and took on board advice and guidance to make a positive difference to the care and support people received. They used information from complaints, mistakes and incidents to learn lessons and improve safety.

There was an open culture at the service which meant staff felt able to raise concerns freely and know that something would be done as a result. People at home, their families and visiting professionals told us the registered manager and management team were approachable and visible.

Staff had received training on ensuring people were kept free from harm and abuse. They were confident in management dealing with any issues appropriately. Good risk assessments and emergency planning were in place. Accidents and incidents were monitored and we noted that these had lessened in this service. Staff were trained in infection control and supported people in their own environment.

Staffing levels were suitable to meet the assessed needs of people in the service. Staff recruitment was thorough with all checks completed before new staff worked with vulnerable people. The organisation had robust disciplinary procedures in place.

Medicines were well managed. People had their medicines reviewed by their GP and specialist health care providers.

Staff we spoke with to displayed a caring attitude. They understood how to support people and help them maintain their dignity and privacy.

There were regular internal and external audits of all aspects of the service. Changes were put into place after evaluation of the service. Good recording systems were in place and these covered all the support needs of the people in the service.