Broadgate Care Home

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 Requires Improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People and their relatives told us they were involved with planning their or their family members’ care. People and their relatives we spoke with felt they could talk about their or their family members’ care needs and feel confident in the support provided by staff. One relative told us, “My family member doesn’t eat a lot, even though they give them options. They give them a fortified heath drink as well. Also, they have at least one, if not two teas on the go, as they know my family member loves their cups of tea!”

People and their relatives were confident that their or their family members’ needs were understood by the staff team. One relative told us how responsive the staff were and how well they supported their family member in regard to their diet. “Oh, they are absolutely great, 100%. They have looked after my family member so well. They have also put on weight too.”

Staff told us they had time to review care planning documents, so they could keep up to date with people’s changing needs. Staff we spoke with showed a good knowledge and understanding of how to support people’s needs, and what action to take if the person’s needs appeared to have changed.

Where people’s needs changed, care planning documents were updated so staff understood any new guidance. For example, where a person’s mobility had reduced, staff had made a referral to an external health team for occupational therapy input for equipment to support their needs. We saw the guidance from the health professional was incorporated into an updated care plan and risk assessment.

People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people, to have a clear understanding of the person’s needs.

A range of national assessment tools were used, to understand people’s needs and how best to support them. For example, the malnutrition universal screening tool (MUST) was used for the management of weight loss and nutritional intake.

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.

We saw care plan reviews had involved the person and their relatives, if appropriate. Relatives we spoke with told us they were involved with care planning and were kept updated on any issues arising. One relative told us, “My family member has [name of specific condition], currently and their care plan has been updated.”

Staff kept records on how they had supported people and at what time. There was consistency in these daily records for food and nutrition, oral care and personal care. The Registered Manager regularly audited planned care records, to identify and address any concerns or shortfalls. For example, where a persons’ skin management needs may require review by an external health care team.

Staff worked in accordance with best practice principles in dementia care. Display boards within the service, showed they supported ‘understanding dementia’ and ‘world stop the pressure day’, which highlights the importance of effective skin management. People’s communication needs were clearly recorded, to enable staff to effectively communicate with people. For example, care plans for people who had specific communication requirements were detailed and personalised. Information for staff to support a person’s spiritual beliefs was included within care plans. Where people may speak in other languages or require the use of accessible information in an alternative language this had been fully considered.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People had clear pre-admission documents in place, detailing their individual needs. The management team assessed their capacity to support people based on the overall dependency needs of the service. The service had a positive relationship with their covering GP practice, who visited regularly to carry out review of medicines or any changes in clinical conditions.

The service worked well with external health and social care partners and implemented guidance from these teams to support people effectively. Staff felt confident in their positive relationships with external partners. One staff member said, “The best thing about working here, is the teamwork. We communicate with each other, even about the smaller things. We include the residents in everything.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff members we spoke with told us about the positive relationships they had with external health and social care teams. The senior team showed professionalism and confidence in raising concerns with the covering GP practice, pharmacy and external health teams. One staff member said, “The primary integrated care service team, do a ward round every Thursday at 10am. The pharmacist is very good at reviewing everything; they call every week and run through all the patients.”

Staff were competent in responding to falls experienced by people. Records showed staff members acted robustly following falls incidents at the service, by increasing their observations for 48 hours. Referrals were made to external teams to help mitigate risks effectively. For example, people who had experienced falls and injuries had been referred to professionals for specialist input to help mitigate this risk. Where referrals had been made, the guidance from these teams had been included within peoples care plans. This ensured people safe and effective support.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

People's needs were robustly assessed, so their care and support could be delivered in line with current standards. This supported people to achieve effective outcomes. Care plans had clear guidance for staff to follow, to ensure people received their planned care and support during the day and at night.

People were supported to maintain good nutritional intake and hydration levels. The service had an experienced kitchen team, who understood where people had been prescribed a specific diet to support with a clinical condition. People and their relatives were positive about the support for dietary needs provided at Broadgate. One relative told us, “My family member doesn’t need assistance, but prompting. They enjoy their food and never leave anything. They always have juice in front of them and regular cups of tea.” We observed people and staff during the lunchtime meal and staff were attentive and supportive where people required this.

Care plans were person-centred, and detailed people’s skills, life experience and strengths. People and relatives, we spoke with had been involved in regular reviews of their plans of care. People and their relatives were positive regarding staff being hardworking and understanding of their needs. A relative told us, “My family member has their favourite staff. They are all good and very polite to me too, and they all know my name.”

Relatives told us they were kept fully informed and given reassurance if their family members were unwell or emergency healthcare was sought for them. One relative told us, “I was very impressed with a recent event, where the nurse called me at 16.00 and explained that my family member was unwell. They called again at 22.00 and said they had settled down and were now asleep. They called again at 07.00 the morning after, to say they had had a peaceful night and were looking much better.”

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment.

People we spoke with all told us staff asked for their consent before delivering personal care. A relative spoke positively about how respectful the staff team were. They told us, “They are, very much so, all of them. Every single one of them from the manager down.” Nobody raised concerns around feeling unnecessarily restricted and relatives explained how their family members preferences were respected. One relative told us, “The staff definitely do this. They always sit and explain what is going to happen. Sometimes my family member agrees and sometimes they won’t. Staff will respect this.”

We checked whether the service was working within the principles of the Mental Capacity Act, (MCA), whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. The service had a highly organised ‘tracker’ in place to ensure people who had restrictions imposed were reviewed regularly to ensure these remained appropriate. Staff we spoke with understood their responsibility to respect people’s wishes and feelings. Where people did not have family members to support them with decision making, we saw the service had engaged independent advocates. This ensured people’s views were respected.