Brun Lea Care

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 changed to Requires Improvement. This meant people’s needs were not always met.

This service scored 50 (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.

Care delivery appeared largely task focused rather than outcomes focused. While staff demonstrated good knowledge of people and their needs, the care provided prioritised completion of tasks rather than consistently promoting people's safety, independence and individual preferences. This included concerns regarding moving and handling practices where equipment was being used without clear evidence of current assessment or professional guidance. Consequently, people did not always receive safe, consistent and personalised care

Care plans were not consistently person centred and did not always reflect people's current needs, preferences, risks or desired outcomes. Several records reviewed were incomplete, out of date or contained conflicting information, which limited the availability of accurate guidance for staff and increased the risk of inconsistent care delivery.

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.

Systems were not always effective in ensuring people's care remained coordinated and consistent when their needs changed. Information was not always transferred accurately between assessments, care plans, risk assessments and other care records. This created a risk that staff may not have had access to complete and up-to-date information when supporting people.

Inspectors found examples where changes in people's health and care needs had not been reflected in care planning documentation. Records contained conflicting or outdated information relating to areas such as mobility, nutrition, pressure care and medicines management. Medication changes following hospital discharge had not always been transferred onto medicines administration records, increasing the risk of inconsistent care.

The provider's admission and review processes had not always ensured that information received from external professionals was verified, incorporated into care records and used to inform care delivery. As a result, people were at risk of receiving care that was not always based on accurate, current and complete information.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was not always presented in a way that fully promoted accessibility and understanding. Inspectors observed menu information which was not dementia-friendly and noted information displayed on a communal whiteboard was faint and may have been difficult for some people, including those with visual impairments, to read.

Care records identified people's communication needs, including where people required glasses or hearing aids to support their understanding and engagement. However, records did not consistently provide guidance for staff about how information should be communicated or adapted to meet individual needs and preferences. This meant staff were not always provided with sufficient information to ensure people could access information in a way they could understand and engage with.

Despite these concerns, inspectors observed examples of staff adapting information, activities and support to help people remain engaged and maintain interests that were important to them. For example, when one person's ability to complete traditional jigsaw puzzles had declined, staff supported them to continue participating in an activity they enjoyed by providing puzzles with fewer, larger pieces. This demonstrated a person-centred approach and an understanding of the importance of maintaining people's independence, interests and wellbeing.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

The provider had arrangements in place to seek feedback from people and relatives, including regular family meetings. Staff demonstrated a good knowledge of people's preferences and supported people to make day-to-day choices about their care and support.

However, care records and assessments were not always updated when people's needs changed. This reduced assurance that feedback from people, relatives and professionals was consistently used to review and improve people's care and support.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

The provider had arrangements in place to seek feedback from people and relatives, including regular family meetings. Staff demonstrated a good knowledge of people's preferences and supported people to make day-to-day choices about their care and support.

However, care records and assessments were not always updated when people's needs changed. This reduced assurance that feedback from people, relatives and professionals was consistently used to review and improve people's care and support.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People generally had access to healthcare services when required and there was evidence of involvement from a range of health professionals.

However, care records did not always clearly identify the support and adjustments some people required to meet their individual needs. This reduced assurance that all people would consistently receive care and support in a way that promoted equal access to opportunities, support and services.

Staff and leaders did not always actively listened to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Systems did not consistently identify when people were experiencing poorer outcomes. For example, significant weight loss, declining appetite and increasing support needs had not always resulted in timely review or intervention. This increased the risk that people with the greatest needs would experience poorer outcomes.

People had differing cognitive, sensory and physical health needs. However, there was limited evidence that the effectiveness of care and support was routinely evaluated to ensure these people experienced the same quality of outcomes as others. Where people's needs had changed, care planning and support arrangements had not always been reviewed promptly to ensure care continued to meet their individual needs.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider had completed RESPECT forms and advance care planning documentation for a number of people. However, people’s future care wishes and end of life preferences were not consistently recorded. This reduced assurance that people had been supported to discuss and record their wishes for future care and treatment.