Oakwood Acquired Brain Injury Rehabilitation Service

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 62 (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.

Care records indicated people received an assessment of their needs prior to admission at Oakwood. It was not always evident that these had been reviewed in a timely way, but work was ongoing to ensure assessment and care plan reviews were happening as needed, with a ‘resident of the day’ scheme implemented to ensure people’s records and care were reviewed monthly. This had not yet fully embedded and we will review this when we next inspect the service.

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.

A full therapy team were in post to support people towards their independence and recovery. They saw people regularly for one to one sessions, and developed intervention plans for care staff to progress. It was not always evident that these programmes of work were being competed by staff. However, people mostly spoke positively about how they were supported, with one person commenting. “I’ve massively improved, I see the physiotherapist most days and am walking and getting stronger.”

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

We received mixed feedback about how the service worked with people, families and other services. Feedback from some relatives raised concerns in relation to communication, and following up on care plans and interventions set by the therapy team. One relative commented, “Communication is poor; I can’t rely on them reaching out to me when something happens.” Another relative told us, “The speech and language [therapist] do a lot of work, they use gestures with people but I have not once seen the other staff using any of the gestures. Family member is scheduled every week to try to increase up to six hours, but I don’t know if they get that.” The provider was responsive to this feedback and told us they would take action to address these matters.

The provider told us they experienced occasional challenges with accessing some services to ensure people had the equipment they needed, such as wheelchairs, but were creative at seeking support from charities where needed.

At the time of the assessment action was underway to create a stable staffing team, with team leaders to run each shift. We observed this was in place and most staff knew the people they were supporting. However, it was not evident that there was always good oversight to ensure care was being delivered in line with care plans, and that people were supported to ensure they were ready for any appointments including with the onsite therapy team. Action to improve oversight was in progress, but not yet embedded.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were not always supported to lead healthy lives and make healthy choices. We received several concerns in relation to how people were supported to eat and drink well. One relative commented, “Food is not healthy at all, burgers, pies all from frozen. Jar of curry sauce. All processed stuff. When they cook the food is rubbish. Sunday is the only exception. [Family member] lives on snacks, and are not eating proper meals.” Another relative commented, “People are on a restricted budget. It’s inconsistent, there is no encouragement to eat healthily.”

The provider was aware of these concerns and was already considering ways to resolve these concerns for people and their families.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Records did not always indicate there was enough oversight to ensure areas of concerns were addressed in a timely way. For example, there was limited evidence that people’s care needs were subject to regular review and that the care detailed in care plans, such as frequency of safety checks, repositioning and support with continence were consistently being completed. The provider had begun to take action to improve the quality of records and new systems for oversight were being introduced.

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

We observed people were generally asked for consent before they were supported by staff although clear records of consent to care and treatment were not consistently maintained in people’s files. Where people lacked capacity there was evidence that mental capacity assessments were completed and best interest decisions being made. Where people were subject to restrictions, appropriate referral for Deprivation of Liberty Safeguards (DoLS) were being made.