Brainkind Neurological Centre York

Updated 15 September 2022

York House is an independent specialist assessment and neurorehabilitation hospital provided by The Disabilities Trust. The hospital, located in York, provides care and treatment for people with who have experienced a brain injury after birth, for example, following a stroke, an accident or undiagnosed health condition, such as diabetes.

The hospital consists of 24 beds across two wards.

The Moors – a 14 bed male ward for assessment and long stay rehabilitation

The Wolds – a 10 bed female ward for assessment and long stay rehabilitation

The hospital is registered to carry out the following activities:

• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Treatment of disease, disorder and or injury
• Diagnostic and screening procedures.

The hospital had a registered manager in place at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2014 and associated regulations about how the service is managed.

At the time of the inspection, there were 21 patients admitted to the hospital. There were 12 patients on The Moors, eight of whom were detained under the Mental Health Act, three were subject to a Deprivation of Liberty Safeguard and one patient was admitted informally. Of the nine patients on The Wolds, five were detained under the mental health Act and four were subject to a Deprivation of Liberty Safeguard.

We last carried out a comprehensive inspection of York House in February 2017 where we rated the hospital as good overall. We rated the effective, caring, responsive and well led domains as good. However, the safe domain was rated as requires improvement; we issued a warning notice and a requirement notice under Regulation 12 (Safe Care and Treatment) of the Health and Social Care Act (Regulated Activities) Regulations 2014. We followed up these concerns with a focussed inspection in October 2017 where we found that the service had addressed the issues. However, following the focussed inspection in October 2017, the safe domain was rated as requires improvement due to further concerns. On this inspection, we found that the service had addressed these concerns.

York House Independent Hospital has been subject to three Mental Health Act monitoring visits since our last comprehensive inspection. We took the findings of the Mental Health Act monitoring visits, and actions the hospital said they had completed, into account during this inspection.

What people who use the service say

During our inspection, we spoke with 11 patients and four relatives or carers.

Patients told us they felt safe on the ward. Some told us they enjoyed being at the hospital and were proud of their progression since being admitted. Most patients felt they were involved in their care plans and their medications were fully explained to them. All patients liked the staff. However, one patient was frustrated that staff did not always keep to the times on their planned programme. Views were varied on activities. Some patients said they were fully occupied; others expressed their views that they did not have enough to do and did not go on as many trips as they would like. Patients had mixed opinions about the food on offer with comments relating to limited choice and small portions.

The feedback from all the relatives and carers we spoke with was positive. They recognised improvements in their family members’ behaviours and progress in their rehabilitation. They received regular contact from the staff at the service and were supported in regular communication and visits. Most of the family members we spoke with, told us they were involved in care planning and that the hospital sought their feedback to help with continuous improvement.

Updated 15 September 2022

Our rating of this location stayed the same. We rated it as good because:

• The service had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices and followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients cared for in a mental health rehabilitation ward and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness and understood their individual needs. They actively involved patients and families and carers in care decisions.
• Staff planned and managed discharge well and liaised well with services that would provide aftercare.
• The service worked to a recognised model of mental health rehabilitation. It was well led and the governance processes ensured that ward procedures ran smoothly

However:

• The premises required regular maintenance work due to its age.
• Emergency equipment and medications were not easily accessible, and locations were not clearly indicated with signage.
• Staff were storing food items in the service’s medication fridge and therefore not following best practice with regards to the safe storage of medicines.
• The service’s fire plan did not accurately reflect the storage of oxygen cylinders.
• Staff did not always follow the provider’s procedures for the recording and disposal of medications.
• The electronic system for recording when medicines were administered did not enable a narrative to the reason a medication may not be given. This was not in line with the provider’s procedures.
• The facilities on the ward did not fully support the privacy and comfort of the patients. Staff were unable to discreetly observe patients in their bedrooms during a night-time without disturbing them.
• Some patients felt food options were limited and portion sizes small. The food supplier did not provide foods to cater for patients requiring level seven food for dysphagia if this were needed.
• Support workers did not feel valued and most staff felt disconnected from the wider provider.

Updated 29 December 2017

Updated 15 September 2022