Frenchay Brain Injury Rehabilitation Centre

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We did not rate caring as this was a focused assessment and we did not cover all quality statements within this key question. We found people were safe and protected from avoidable harm. We reviewed independence, choice and control quality statements for the caring key question. Most people said they were treated with kindness and their privacy and dignity was usually respected. People were supported to make their own decisions and be understood. People had choices around visiting times, activities and keeping in contact with families remotely as Wi-Fi was available at the service. However, Wi-Fi signal was often intermittent. People had equipment for their needs and were offered support with aids and tools following discharge. Teams worked collaboratively to provide personal care. However, people would have liked more regular care. Therapies sessions were sometimes cancelled. People were not always clear about the nature of their injuries and did not always understand who oversaw their care.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We did not look at Kindness, compassion and dignity during this assessment. There is no previous rating for the Caring key question so we cannot yet publish a score for this area.

We did not look at Treating people as individuals during this assessment. There is no previous rating for the Caring key question so we cannot yet publish a score for this area.

People told us staff accommodated their needs by extending family visiting times and they had a choice of food and drinks. People said staff protected patients’ privacy and dignity when providing treatment and organised individual and personalised activities for patients. People told us Wi-Fi was provided but the connection could be poor which meant it was difficult for families to keep in contact with patients remotely. People told us some staff were very kind. However, some people told us staff did not always listen to patients’ views. Some people said there were not enough staff to give patients more than 2 showers per week with washes or bed baths in between.

Staff said they supported patients and relatives’ ability to communicate remotely and by staff receiving or making calls to update relatives. Staff said they took time to interact with patients and relatives in a considerate way and would raise concerns if any disrespectful or discriminatory behaviour was witnessed. Staff provided support to patients and relatives by meeting with them and told us each patient should have had a keyworker. However, we did not find evidence of designated keyworkers in patient care records and they were not discussed at staff meetings. Staff said they included relatives when discharge planning and provided information and advice regarding support services. Staff said they respected patients’ privacy and dignity needs and worked in pairs for safeguarding purposes. Staff knocked on doors of individual rooms before entering and pulled down blinds before carrying out care. Staff told us they were always able to access equipment required for the care and treatment of patients. Staff told us they had created a faith room for staff and patients in response to patient feedback about needing a space to pray.

Patient review meetings were attended by the multidisciplinary team, patients, families and outside agencies. Detailed care requirements were documented. Discharge plans were discussed including specialist care needs and ongoing therapies. Funding for equipment required was discussed regarding costs and timeframes. Activities were provided for patients Monday to Friday, including bingo, quizzes, pottery, walks, movies, barbeques and dog therapy. This was reviewed regularly and changed in response to patient feedback. Shower schedules listed patients having showers twice weekly with washes or bed baths in between. Nursing and Occupational Therapy (OT) staff worked collaboratively to shower patients. There was a visiting arrangements policy. This was to ensure visits to see patients were managed safely and they facilitated flexible visiting times for patients, families and friends. There was a policy to support patients’ communication with relatives. There was an action plan to address the intermittent Wi-Fi signal issue. However, this had not been resolved. Patient surveys were conducted regarding care and treatment. Feedback was mostly positive. Patients felt safe and knew what was happening every day. However, some people told us therapy sessions were occasionally cancelled at short notice. Most patients were not sure who oversaw their care and around half felt they had not received information about their injury. They did not feel they could ask further questions. Leaders responded to patient feedback. There was an action plan to address these concerns. Before discharge, patients were taken on practice shopping trips and spent time in the on-site practice living flat. Discharge reports provided information about community support following discharge including levels of care required, funding and referrals to community teams.

We did not look at Responding to people’s immediate needs during this assessment. There is no previous rating for the Caring key question so we cannot yet publish a score for this area.

We did not look at Workforce wellbeing and enablement during this assessment. There is no previous rating for the Caring key question so we cannot yet publish a score for this area.