Bramble House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. When we last assessed this key question it was rated good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 70 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff treated people with kindness and compassion and respected their privacy and dignity. A dignity champion and lead promoted and supported core values which supported dignity in care, such as respect and compassion.

One relative described staff as being “really caring” and another said, “Some staff are really nice, and some are just nice. I haven’t seen anyone who isn’t nice.” A professional advocate who visited regularly said, “I have only ever seen positive interactions with staff and residents. One of the ladies likes to have a hug and staff will give her time.”

Staff were observed speaking to people in a caring and respectful manner, and interactions were warm and friendly. A member of staff said, “Staff here are very caring and speak to people how they would like to be spoken to.” When asking 1 person if they felt cared for, they said, “I am happy here” and another person said, ‘Staff are friendly and nice.”

Staff understood the importance of confidentiality and people’s care records were kept secure. A member of staff said, “I never see anyone that I've worked with who has not used confidentiality. Not seen it. My colleagues are very respectful and know what confidentiality means and what is important.”

Staff took the time to learn about people’s life histories including what was important to them. Staff encouraged people to converse and express their feelings to support their well-being. Staff responded calmly when people became distressed, helping people to feel valued and reassured. We observed staff supporting a relative when they became upset during a visit to their family member.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Care staff supported people in line with their individual needs, preferences and protected characteristics. Care plans included details about personal likes and dislikes, and staff were seen tailoring care accordingly. A relatives said, “They know my (relative) and do their best.”

Housekeeping staff also treated people as individuals recognising people’s differences and preferences, flexing their work around these. Examples, included cleaning 1 person’s bedroom around that person’s preferred daily routine and with another person, choosing moments of well-being when the person was able to provide consent for them to access their bedroom. The maintenance person also knew people on an individual basis, and we observed them interacting with people as they worked.

Some people had set daily routines which staff respected and worked around, an example being, 1 person preferred to get up later, be supported to wash and dress and then eat breakfast; we observed this being met during this assessment. Another person’s daily routine involved set tasks at set times which they enjoyed completing and which supported their mental health. All staff were aware of this and supported this person to achieve these.

Activities supported people’s individual interests, abilities and needs and included art and craft sessions, gardening, singing and music. People’s religious beliefs were supported with the activities co-ordinator arranging links with local churches and community groups.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and well-being.

Staff supported people’s independence by ensuring they understood their rights and were supported to make choices about their care and daily routines. Staff encouraged decision‑making and adapted their approaches, particularly when supporting people living with dementia, drawing on different colleagues’ rapport with people to help.

People were supported to make meal choices, though some would have benefited from visual aids such as sample plates. When individuals declined the available options, staff quickly arranged alternatives.

People moved freely and safely around the home, including accessing the garden, which helped some individuals regulate their emotions. Relatives confirmed that people could choose how they spent their time. A relative said, “(Relative) has the freedom to choose what (relative) wants to do and can wander around the home (ground-floor).”

The activities coordinator facilitated community access, including walks, local outings and dementia choir sessions, though participation varied depending on people’s health or preferences.

People received visitors without restriction and were supported to spend time with family outside the home. Staff recognised the importance of enabling choice and control to promote people’s well-being.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

We observed staff being aware of people’s changing needs and acting quickly to support people’s immediate needs. One person had become unwell during lunch and staff responded to their immediate needs, providing comfort, reassurance and organising the monitoring of their health observations, such as pulse and blood pressure readings.

Guidance for staff to follow when people’s health deteriorated had not been in place, this had also not included a relevant policy with procedures for staff reference. The provider rectified this at the time of this assessment, providing a relevant policy, a flow chart as a quick guide for who to contact and when, including additional training with scenarios to support staffs’ understanding and competencies of the actions to take when people’s health deteriorated.

Relatives confirmed they had been informed quickly about health concerns which had arisen unexpectedly and staff had arranged a follow up by healthcare professionals. One relative told us staff knew her family member well and they recognised when they were not well and would get them the care they needed. One relative felt the staff had not recognised their family member’s decline in health in a timely way.

We observed call bells being answered promptly so people’s immediate safety or distress was responded to. We observed that people’s mental well-being could alter quickly and that staff were aware of this. Staff knew who was more susceptible to this and what could trigger distress and they responded quickly to provide reassurance and adopt strategies which would support the person’s well-being.

The provider’s arrangements did not always effectively promote and support staffs’ well-being.

We received mixed feedback from staff about how they felt their well-being was supported at work. One member of staff said, “They do make sure our well-being is looked after here” but also told us they had been made to feel a nuisance when they had sought support from a manager. Another member of staff said, “They make me feel reassured. I know I can sit with (Manager), and she will make me feel better.” However, the feedback we received was predominantly not positive and was linked to a perceived lack of staff, lack of issues getting resolved and high workload. One member of staff said, “I think communication between management and staff regarding staff needs is poor” and another said, “I don't always like the way that management speak to staff.”

The provider’s well-being and enablement arrangements included support for staff to take breaks when on duty and to take their entitled leave. Staffing rotas were completed in advance allowing staff to organise their personal lives. A flexible working policy supported arrangements, where needed, for staff to work flexible hours. The staff meetings and staff supervision sessions were also held so issues could be discussed between staff and managers.

The feedback received told us that despite these arrangements, there remained issues which were not getting resolved and which were having an impact on staff well-being at work.