Bryony 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 service met people’s needs.

At our last inspection we rated this key question good. At this inspection the rating changed to requires improvement. This meant people’s needs were not always met.

This service scored 46 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. People did not always have care and support plans specific to them. Staff did not know people’s needs, preferences or personal circumstances to be able to respond to them effectively. Relatives did not feel involved or informed about people’s care planning. One relative said, “There wasn’t a care plan made.” Another told us they don’t believe any care plan was made and they have not been involved in any reviews. One other relative stated they had never seen a care plan but had just the odd conversation with staff and nothing else. The lack of detailed and individual care planning put people at the risk of inconsistent care which failed to identify or meet their needs.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. Not everyone had a specific plan identifying what was important to them or those close to them. They did not have responsive plans in place to drive good care provision or integration in the community. One person told us about going out to the shops but we were later told by staff they couldn’t as it was not safe. However, the provider had failed to complete the necessary assessments to safeguard this person before deciding for them. Not all information about people was assessed or known by staff. This meant not all information important to the person could be passed to other healthcare partners when it was required putting the person at risk of delayed or inconsistent care.

People did not consistently have their communication preferences assessed. This resulted in staff not working in a consistent way when supporting and communicating with them. We saw 1 person was not engaged when a staff member was supporting them. The staff member failed to provide any information to the person on what they were doing and they failed to offer the person any choice. The staff member did not identify the best ways to engage the person to ensure they were at the centre of the interaction. We saw another person was provided with their medicines. The staff member was talking on their phone throughout and did not communicate with the person at all during this interaction. The person was not provided with any information regarding their medicine, what it was for or if they wanted it. The staff member then ended the interaction by walking away whilst still talking on the phone. This lack of valuing communication and engagement removed people from making informed decisions about their own healthcare.

People and relatives felt they could talk with any staff member or the management team if they wanted to. However, people’s response to raising concerns differed. For example, 1 person told us they had raised their concerns with the management team but felt nothing ever changed as a result. We confirmed the management team knew about this issue but failed to record it or action anything as a result. Others felt the management team were responsive to concerns and felt happy to talk with them. This inconsistency in experiences for people and relatives did not reassure those living at Bryony House they would receive a positive and consistent response to being listened too.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Relatives’ experiences differed regarding their family members equal access to services. Some believed their family members were referred on promptly when needed whilst others felt they had to keep pushing the management team for referrals to healthcare partners. We saw 1 instance where a delay in communication with GP’s contributed to a delay in medicine being administered. One relative told us they had to keep on at the management team to refer their family member for a medicine review and following this they were not informed about any changes. The inconsistency of people’s experience put people at the risk of receiving inequity in accessing other healthcare services.

People, their experiences and their desired outcomes were not consistently known by the management team or those supporting them. This stemmed from a lack of consistent care and support planning. Not everyone’s life experiences were captured as part of the providers assessment process. This resulted in key aspects of the person including, disability, sexual orientation, race or religion not being consistently or effectively identified or recorded. This meant care planning or interactions could not be effectively planned with the person in a way which ensured their experiences were positive and met their needs, wants and desires. People were at risk of inequality in experience or outcomes as a result. We saw care and support plans which were left blank and very little about the person was known other than their immediate needs.

People were not always supported to plan for important life changes, including at the end of their life. The management team recorded functional and task centred aspects of people’s future wishes including funeral arrangements and a desire to remain at Bryony House. However, the personal aspects and preferences were not recorded in people’s future wishes. We spoke with the management team, and they believed this was just about the practicalities as people moved to this stage of their life. People did not consistently have their aspirations, ambitions or goals recorded. There was inconsistency in recording what people could do for themselves or improvements they desired to make to become more independent or to improve skills or pursue interests or hobbies. This lack of consistency for planning people’s future experiences put people at the risk of having their aspirations unfulfilled.