Care Quality Commission Report, 2013

The Care Quality Commission scheduled inspection of Newbridge House on March 20, 2013.

The inspectors considered standards in five different areas:

  • Care and welfare of people who use services.
  • Management of medicines.
  • Requirements relating to workers.
  • Complaints.
  • Consent to care and treatment.

Comments from parents and young people included in the report

“I have no concerns and if I did, I am very confident they would work to address it with us”.

Relative.

“Everyone is respectful here”.

Young person in inpatient care.

“The psychotherapy sessions are good”.

Young person in inpatient care.

“I have no concerns at all. It is very good here. They explain everything very well”.

Relative.

Summary of inspection findings on the five standards

Care planning and quality at Newbridge House

The inspectors assessed the care plans for six young people in inpatient care at Newbridge House. They commented:

“We saw that care plans were person centred, this meant that they reflected the individual person’s needs and choices as far as possible. Due to the health conditions the people who used the service had, some elements of the service were therapeutically restrictive of people’s choices. We found that the care plans included self-assessment by the people who used the service, as well as the assessments from the multi-disciplinary team. We saw that there were also people held notes, which were age appropriate and recorded their daily progress in their own words. This meant that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.”

“We saw that the level of observation required, its frequency and method were clearly documented in the person’s care records. This meant that care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare.”

CQC judgement: Standards are met. People experienced care, treatment and support that met their needs and protected their rights.

Management of medicines

The report describes that all systems for ensuring medicines are safely stored and administered were in place.

CQC judgement: Standards are met. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Requirements relating to workers

Newbridge House’s inclusive approach to recruitment was noted, involving service users in new staff interviews where possible. Inspectors comment:

“We saw that the people who used the service were encouraged to participate in the selection process for new staff, and where possible to be part of the interview process. This was confirmed by some of the staff we spoke with during the inspection. We saw that the service had a documented process to support this inclusive recruitment practice.”

Inspectors also noted that we were following best practice in terms of safe recruitment.

“We saw that clearly documented processes were available which included both permanent and agency or other temporary staff. This meant that appropriate checks were undertaken before staff began work.”

CQC judgement: Standards are met. People were cared for, or supported by, suitably qualified, skilled and experienced staff.

Complaints

Inspectors noted the approach taken at Newbridge House, to provide as many different routes for feedback and complaints as possible, to ensure people can find a route to communicate and the service is fully responsive. The report notes:

“We saw that the complaints process was clearly documented and available in the main reception area. We saw that the process acknowledged complaints within three working days. A detailed response would be sent to the complainant within 20 working days. The complaints policy was also available on the service’s website. The business manager told us that it was important that people were able to complain via whatever route they found easiest.”

CQC judgement: Standards are met. There was an effective complaints system available.

Consent to care and treatment

Two issues were identified which meant Newbridge House was not meeting standards in consent to care and treatment. This were consent to sharing a room and the frequency for explaining rights to consent to treatment, particularly if patients are under the Mental Health Act. The report states:

“We saw that within the care plan there was a consent form, which included the person’s consent to remaining on the premises, participation in therapy sessions, supervision and searches. This meant that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. However, we could not see that consent was sought or recorded in relation to sharing a room, or changing room. The business manager told us that they discussed this, and that a spare bed was always available if a shared arrangement was not working.”

In relation to capacity to consent form, the report states:

“We found that the consent form did not specify the level of understanding that the person who used the service had regarding their rights, if they had been detained under the Mental Health Act. The form did not capture how frequently people who used the service would be reminded about their rights where this would be appropriate.”

Response from Newbridge House to the latest CQC inspection report:

“We are very pleased with the findings of this report – the many positive comments from young people and parents, the standards met and the opportunity to reflect on the service we provide. The inspectors assessed our care planning in great detail and we are very pleased that this is reflected in the report, as is our compliance in key standards such as staff recruitment, complaints procedures and safe medicines management. We have already implemented the recommendations from the report in terms of consent and welcome this guidance from the CQC.”

Jane Edwards, quality assurance lead, Newbridge House.

“We are very pleased with the findings of this report – the many positive comments from young people and parents, the standards met and the opportunity to reflect on the service we provide.”