We carried out a review of the data available to us about Haydock Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Haydock Lodge, you can give feedback on this service.
TRU ABI rehabilitation centre offers support for up to 30 people who have an acquired brain injury. The service can provide care for people who are detained under the Mental Health Act 1983. The service is based in a rural setting, in the area of Haydock, which is located between Liverpool and Manchester. There is easy access via motorway networks with car parking on site. The centre is purpose-built to be fully accessible for people with physical disabilities.
The service comprises three units, Newton, Willows and Lowton. The Newton unit accommodates people who have been detained under the Mental Health Act. Because of this the unit was inspected by inspectors from the hospitals (mental health) inspection team.
At the time of our inspection there were two people living in the Newton unit, six people living in the Willows unit and four people living in the Lowton unit.
The service had a registered manager in post. 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.
At the last inspection on the 16th and 17th of June 2015 there were three breaches of regulation in relation to the safe management of medicines, the management of complaints and ineffective audit systems. We asked the registered provider to take action to address these areas.
After the inspection, the registered provider sent us an action plan that specified how they would meet the requirements of the breaches identified. They advised us that they would meet all the legal requirements by February 2016. During this inspection we found significant improvements had been made across all areas and the registered provider was able to demonstrate full compliance with the Health and Social Care Act 2008 (Regulated Activities) 2014.
Medicines were managed safely and clear processes were in place that ensured people received their medicines on time and ‘as required'. Medicines were stored, administered and recorded in accordance with the registered provider's policies and procedures. All staff administering medicines undertook annual competency assessment and training.
People knew how to raise concerns and complaints, and felt confident to do so. Records showed people were fully involved with the complaints process and the registered provider followed their procedures.
Improvements were demonstrated within the registered provider’s quality assurance systems. Action plans evidenced areas for improvement and development and these were addressed in a timely manner. Actions were signed and dated when completed. People's feedback was sought and the management team used this for service development.
We have made a recommendation for clinical supervision to be undertaken with staff working within the Newton Unit.
The service demonstrated safe recruitment practices. All new staff undertook appropriate checks prior to them commencing employment. All new staff received a thorough induction which included a period of time shadowing experienced staff. All staff received regular mandatory training to ensure they remained up to date with their knowledge and skills required for their role. There were sufficient staff to meet the needs of the people living at the service.
People's needs were assessed prior to them moving into the service. Individual risk assessments were completed to ensure people and staff were protected from the risk of harm. Staff promoted people's independence wherever possible. Care plans were person centred and gave clear guidance to staff to meet people's individual needs.
All staff had received regular training in adult safeguarding and were able to demonstrate a good understanding of how to recognise and report signs of potential abuse. There were clear policies and procedures in place that informed staff of how to keep people safe and these were followed.
People were supported to participate in activities of their choice. People spoke positively about the way staff treated them and said that they enjoyed spending time with staff. We observed positive interactions between staff and people living at the service.
This was an announced inspection, carried out on 16 and 17 June 2015.
TRU ABI Rehabilitation Centre provides care and support for adults who have an acquired brain injury. The service can provide care for people who are detained under the Mental Health Act 1983. The service is in a rural setting in the Haydock area which is between Liverpool and Manchester. There is easy access via motorway networks with car parking on site. The centre is purpose built so is fully accessible to people with physical disabilities.
The service comprises of three units, Newton, Willows and Lowton. The Newton unit accommodated people who had been detained under the Mental Health Act and because of this the unit was inspected by inspectors from the Mental Health inspection team.
At the time of our inspection there were nine people who used the service. Five people were living in the Lowton unit, two people living in the Willows unit and three people living in the Newton unit.
The service had a registered manager. 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.
Risks people faced were identified, managed and reviewed and the staff understood how to keep people safe. There were sufficient numbers of suitable staff to meet people’s needs and promote their safety. People who used the service told us that the staff treated them with compassion, dignity and respect. Staff listened to people and encouraged them to make choices and decisions about their care and support. Staff sought people’s consent before providing care and support. Some people who used the service were unable to make certain decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed.
People who used the service told us they felt safe. Staff had attended safeguarding training and knew what action to take if they suspected people were put at risk of harm or injury.
Staff had completed training that enabled them to meet people’s needs effectively and the development needs of the staff were monitored by the management team.
People’s health and wellbeing needs were monitored and people were supported to attend health appointments as required.
We found that people were not always protected against the risks associated with the administration, use and management of medicines.
People knew how to make a complaint, however we found that complainants were not dealt with in accordance with the registered provider’s procedures and were not responded to in writing with an outcome or apology once the investigation had been conducted.
Feedback was sought from people and their relatives about the quality of care that had been provided. Audits were routinely repeated without proper consideration of improving and stretching the parameters of the audit so that continuous improvement was evidenced.
You can see what action we told the provider to take at the back of the full version of the report.
People were encouraged and supported to participate in activities that took place at the service and in the local community.
The registered manager understood the requirements of their registration with us. Staff working at the service were positive about their role and the service provided to people. They had been appropriately recruited and supported. We saw that staff provided care in a way that centred on the individual needs of the people who used the service.
During inspections we routinely ask five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This visit however was a follow up visit to see if rehabilitation provided to people who used the service had improved. This had meant that the service was not responsive to the needs of people and that the service did not promote the independence of people
We asked if the service is responsive and is the service caring?
The service was responsive
We found on this visit that action had been taken to ensure that care plans were adhered to and that all people who used the service received the appropriate support from other professionals in relation to their rehabilitation. We saw that arrangements for professionals to meet and discuss people's progress had been reviewed and now included all people involved with a person's rehabilitation. People who used the service told us that staff were 'helpful and responsive'
The service was caring
We spoke to three people who were living in Newton Unit (a secure unit) during the time of our visit. One told us that 'staff were helpful'. The other told us 'staff do what they can to help us'. Another person was negative in their comments. This related to their recent experience of having a setback in their rehabilitation. Staff told us that they had sought to reassure this person that they would progress. We observed interactions between people and staff and found them to be positive and supportive.
We found that the provider followed the 1983 Mental Health Act Code of Practice.
At this inspection we found improvements had been made. We looked at a sample of staff rotas, to check if the correct number of nursing staff were working on each shift and if agency staff were still being used. We found the staffing provided was sufficient to meet the needs of the people living at the service. There were two qualified nurses working each shift. Agency staff had not been used on the rotas we looked at.
We looked at the care records and found they contained all of the relevant documents to support a person safely. We found the provider [owner] had accurate and up to date records which related to the running of the service.
We looked at the care records for three people who lived on Newton Unit and three for people who lived on Lowton Unit. We saw that some people were not receiving rehabilitative treatment or therapy as stated in their care plans.
We went with a Mental Health Act Commissioner. The Mental Health Act Commissioner considers whether the Mental Health Act and the Mental Health Act Code of Practice is being followed. They also proactively visit and interview people who are detained under the Mental Health Act. The Mental Health Act Commissioner interviewed a number of detained patients and made contact with some others.
We found that the centre was the essential standards relating to consent, care and welfare, safeguarding, supporting staff and monitoring quality. The centre was not meeting the essential standards relating to the requirements regarding having sufficient staffing levels and the requirement in relation to records.
We found care files contained detailed assessments of care needs and assessments of risks for each individual. There was good background information about each person, including hobbies and interests, and any cultural needs.
We saw that when care plans were implemented and reviewed, individuals were fully involved, as were relatives or advocates. When people were unable to make decisions for themselves, best interest meetings had taken place and were well documented.
Following the last inspection we found that restraint of a person who required treatment on a regular basis was not undertaken within the MHA code of practice (1983). We assessed this standard again to review what action had been taken.
When we reviewed the care files and daily records we found action had been implemented to ensure that when any restraint was applied, this was recorded fully.
There were appropriate systems in place to monitor and manage the maintenance of the centre. Contracts were in place for waste collection and service and maintenance of equipment.
We observed coaches, nurses and other members of the staff team engaging with people in a positive way.