Bradbury House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

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

This meant people’s needs were met through good organisation and delivery.
 

This service scored 79 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans were mostly person-centred and placed people’s needs and preferences at the centre of the support provided. Care plans included information about people’s backgrounds, interests, dislikes and what was important to them, such as their life history, hobbies, daily routines and personal preferences, to support staff to provide personalised care. We observed there were some inconsistencies with personalisation and the provider were already working on this based on the results of a mock inspection which had taken place prior to the assessment. People confirmed staff supported them in an individualised way which evidenced staff knew people well.

We observed that staff had a good understanding of people’s individual needs and preferences and adapted their approach accordingly. They were able to communicate effectively with people and understood their individual communication needs.

People’s bedrooms were personalised in line with their preferences. Photographs displayed around the service showed people taking part in outings and activities, reflecting a positive and inclusive environment.
 

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

There were consistent and longstanding members of staff supporting people, which meant continuity of care was maintained. This helped ensure staff understood people’s needs, preferences and routines, leading to more personalised and effective support.

A relative told us, “They also really know my [Family Member’s name] and understand [their] needs”.

Staff worked effectively with health and social care professionals. A range of professionals visited the service regularly to review and respond to people’s needs. Referrals were made to appropriate services, such as speech and language therapists, occupational therapists, GPs and district nurses, when people’s needs changed.

Staff supported people to settle into the service and worked to ensure they felt comfortable. Families and representatives were kept informed and involved and feedback indicated people were happy with the support they received. This meant the service was meeting people’s needs and providing care in a way that promoted their wellbeing and satisfaction.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff were able to use a range of communication tools to ensure information was accessible to everyone, where these were required. This included using large print, a hearing loop and the use of voice activated speakers. There was a quarterly newsletter which could also be made available in other formats. The newsletter was written and led by a person who actively interviewed staff, people for their views and gathered articles.

Staff told us they had access to the provider’s policies and procedures and stated they were aware of how to find this information.The electronic policies included features that could translate the information into a different language, read the text aloud, and change colour contrasts to support staff with any communication or language needs. This meant staff were well informed and able to follow up-to-date guidance, to ensure people and relatives received information in a way that suited their individual needs.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider sought feedback from people and those close to them in different ways. This helped ensure people’s views were listened to and considered. Where feedback identified areas for improvement, development plans were put in place to drive change and improve the service. For example, people told the provider they had concerns about the food. In response, the provider implemented regular food forum meetings, which enabled people to raise their concerns and discuss ways that they wished for their concerns to be addressed. Within these, the management were able to provide responses and updates directly to people. Minutes were also shared with people who were unable to attend. Alongside this, the provider was seeking feedback from people after their meals and had also put in place a comments book in the dining room for people, residents and visitors to use. This meant that people felt empowered in decisions made around the meals and food provided in the service.

There were quarterly residents’ meetings for people to attend. We observed that these were well attended. They showed comments and suggestions from people, actions to be addressed and updates from actions previously discussed.

There were twice annual garden meetings for people to voice their feedback or suggestions for planned upkeep of the garden area. A garden communication book for people, relatives and visitors to use. This enabled people to be part of and suggest improvements for this valuable space. Minutes were shared and/or read to people who were unable to attend.

People were also involved in the production of a regular newsletter for the service with many people contributing to articles in it.

Complaints were regarded as a way to drive improvements within the service and registered manager evidenced there were clear processes in place to record and act on complaints.

One relative told us that they had previously raised complaints about the food. They told us, “This was raised at a meeting…[it is] now certainly improving.”

This showed the provider actively listened to people, valued their feedback and used it to make improvements, supporting a culture of continuous learning and person-centred care.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Staff and management supported people to access external healthcare resources when they needed, as well as having regular visits to the service from people such as the GP, district nurses, chiropodists and physiotherapists. People’s care plans also contained evidence of regular appointments with healthcare professionals.

The provider had an accessible vehicle, which included a tailgate lift. This enabled people with mobility needs to attend healthcare appointments, visit family and friends, and participate in activities within the wider community.

We observed staff supporting people to have their COVID boosters during the visit and ensuring health professionals were supported in administering these. The registered manager also advised a person had requested they attend an external appointment with them during the assessment. This demonstrated the provider used staffing flexibly to ensure people could access external healthcare appointments safely and without delay, providing choices as to whom they wanted to attend with them and supporting equitable access to healthcare services.

One relative told us, “The doctor does his weekly round, which is good. There is a great chiropodist too. They are good at helping residents with transport to outside appointments”. A health professional told us that staff were proactive in supporting people to access health services they required.

This meant the staff worked proactively with healthcare professionals to monitor and respond to people’s health needs. People had good access to routine and specialist support, and staff took appropriate action when concerns arose. This demonstrated a coordinated approach to care, helping to maintain people’s health and achieve positive outcomes.
 

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider worked in line with equality and human rights legislation, ensuring people were not discriminated against and their diverse needs were recognised and respected. Staff were aware of potential inequalities and took action to reduce barriers and improve people’s experiences. For example, changing their approach and communication style depending on the persons’ needs.

A relative shared when their loved one’s needs changed, staff proactively adapted their approaches in order to support them. They told us, “They have a difficult condition and sometimes refuses [support]… but somehow, they have the gift to manage [them]. [The service] have managed all this, changing [their] care plan as [their] needs change, and adapting [their] medication accordingly”. This demonstrated the provider’s commitment to providing tailored care, ensuring equitable health outcomes by offering bespoke support rather than a one-size-fits-all approach.
 

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

The service was accredited by the Gold Standards Framework, which is a practical and evidence-based end of life care service improvement programme. This had enabled the service to enhance their understanding, training and approach in supporting people and their relatives in planning their end-of-life care. To be accredited, the service had been externally assessed and demonstrated quality standards in the support they provide around the end of a persons’ life. In addition to this, the service had been awarded the Quality Hallmark Award after successful reaccreditation for sustained practice in this area.

The provider was extremely proud of this achievement, and they placed a high priority on enabling a good and dignified death. In addition, the service has provided support to other services seeking Gold Standards Framework Accreditation, demonstrating its strong commitment in this area of care. The deputy manager led on Gold Standards Framework care and actively promoted best practice throughout the service. They ensured staff received appropriate training and were empowered with the knowledge and skills required to provide appropriate and compassionate support to people at the end of their lives.

Care plans included details of end of life wishes, funeral wishes and their preferences around their last days of care. This ensured people had been fully consulted and were able to make future choices and personalised decisions for themselves at a point in their life where they may not have been able to do so.

We saw evidence of this in feedback from relatives. They said they also felt well supported by staff, with staff going “out of their way” to provide “exemplary” care and “loving” support in accordance with the persons’ wishes during the final days of their lives.

Staff spoke passionately about the end-of-life training and support provided at the service. Staff commented, “Bradbury House offers training for end-of-life care. It is essential to recognise the dying phase so that we can address the physical, psychological and spiritual needs of [people]. l can provide a dignified care, manage pain and handle complex symptoms to the dying person. The training helps us to support families to reduce the emotional stress of the end-of-life journey of their loved ones.”

Health Professionals told us “The service’s End of Life Care is impeccable. They go above and beyond [for the people they support]. They use good methodology and staff fully understand the reasons for changes in need”.