Bradbury House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.
 

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People had individual care plans and risk assessments in place which had been developed to meet their current needs. People and other specialist healthcare stakeholders were involved in the initial care needs assessment and periodic review of their care needs where appropriate. People confirmed they were involved in the assessment and regular review of their needs.

People’s healthcare needs were assessed and detailed in their care plans. People were supported to engage in community healthcare services, as well as more specialist healthcare services, to ensure their health care needs were met.
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff had a good understanding of the people they supported, and we observed them using good practice in supporting people with their eating and drinking. Assistance with meals was calm and made into a social occasion with staff checking the food was being enjoyed as well as chatting about current events and making jokes.

The service employed the use of an external catering company to run their kitchen. Due to this, we observed there was a reliance on care staff to advise of the nutritional needs of people. The registered manager was already aware of this and had taken steps to address this with the catering company.

We observed people were given choices of food. We saw that people were referred to the speech and language therapist (SALT). They provide assessment of swallowing or communication difficulties for people with medical, neurological and surgical conditions.

After the inspection, the provider told us that they use NEWS2 (National Early Warning Score) for the early recognition of deterioration and timely escalation to healthcare professionals where required

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff demonstrated effective team working and maintained positive relationship with external professions, including health and social care services.

Meetings were held with relevant health and social care professionals to ensure care was tailored to meet people’s immediate or changing needs and to ensure all avenues for people’s wellbeing were considered.

Health professionals told us all staff worked well in flagging concerns, had “great” communication skills, providing assistance with chaperoning and health advocacy for people. People told us they had access to a range of health professionals and if they needed support with attending appointments the service “Would arrange to take me”. Relatives also told us the service were “Good at organising outside appointments”.

Within the service, they held regular team meetings and clinical review meetings to gather, record and update information for people whose needs may have changed. These were then used to update care plans, make relevant referrals and ensure staff understood any changes in support for people.
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People told us they were able to see doctors and other healthcare professionals when needed and were satisfied with the support they received. Health professionals told us staff were good at recognising and responding to changes in people’s needs and made referrals in a timely manner.

Guidance from healthcare specialists was recorded in people’s care plans, which enabled staff to provide professional and clinical support appropriately. For example, one person was referred to a speech and language therapist in relation to their condition, and another person was referred to a dietitian for assessment. Staff demonstrated they followed this advice in practice, such as supporting dietary plans in line with professional guidance. There were some inconsistencies noted and the registered manager provided reassurance these issues had been reviewed. For example, food and fluid charts differed around the amount of fluids provided to a person. The registered manager advised this was an already identified area for improvement. They were in the process of reviewing how these were overseen, audited and staff would be reminded of appropriate recording for these.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider used a range of quality assurance systems, including residents’ meetings and surveys, to review people’s experiences and outcomes. Monthly audits of care records, care plan audits, regular check-ins by key workers and feedback from people and staff helped identify areas for improvement. Where improvements were needed, the service were quick to develop action plans action plans which were reviewed to support better outcomes.

The provider employed a dedicated physiotherapist who attended the home on a weekly basis. This provision supported people living at the home to maintain mobility, independence and physical wellbeing, as well as supporting rehabilitation and falls prevention. The physiotherapist spoken to during the inspection confirmed this arrangement and their involvement reduced hospital admissions, falls and referral waiting time.

People and their relatives told us staff supported them to maintain their wellbeing as much as possible to improve their individual outcomes.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

We observed that staff understood the importance of promoting choice and obtaining consent before delivering care. People and their relatives confirmed that staff sought consent before providing support.

People told us their views and wishes were considered when planning their care. People’s capacity to consent was assessed and considered where needed. Information was provided in a way people could understand, and they were supported by staff to make decisions.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the provider was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met.

The provider undertook mental capacity assessments where this was required. However, records could be improved to evidence the steps taken in supporting people to take part in this process, as this was not always clear. We also observed that some sections of the best interest checklist had not been fully completed and did not evidence actions had been taken by the provider, although this was evidenced elsewhere in the care plan. We observed that DoLS were applied for where required.