Brookfields Private Nursing 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 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 67 (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. However, improvements to care plans and risk assessments were still needed and had not yet been fully embedded.

Leaders were working to an action plan with partner agencies to update care plans and risk assessments to ensure they contained the required details to help ensure people received the care they needed. Leaders had involved people and their relatives in this process to ensure they reflected people’s views. One person told us, “Staff have spoken to me about my care plan and they made notes.” A relative said, “Yes, we’ve got a care plan for [family member]. We were consulted about it, and care plans have been changed as their health has improved.”

However, care plans and risk assessment improvements had not yet been fully embedded. We found some instances of when they had not been reviewed or updated when people had had falls. Not all potential restrictions had been assessed in people’s mental capacity assessment care plans.

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.

People were happy with the food and drink choices available to them. One person said, “The food is not bad. There’s always a choice. You can always have a jacket potato and some ladies prefer to have egg and chips. Today it was corn beef hash and pasta bake. I tried the pasta and garlic bread.” A relative told us kitchen staff had, “Gone out of their way,” to meet their family member’s preference for meal choices. They said, “[This meal] is bought in for them and another person who really likes it. Staff are really accommodating. So, like today, today’s choice isn’t suitable for [person] so they are having a jacket potato and cheese instead. In the evenings if they fancy something different staff will do whatever they want; I’ve even known staff do them a chip sandwich if that’s what they really fancy.”

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.

Staff told us they worked well together and communicated with each other through handover meetings and team meetings. Meeting minutes showed areas relevant to staffs’ job roles had been discussed.

People told us they felt staff had positive attitudes and that they helped to create a warm and friendly atmosphere. One person told us, “The carers are brilliant. They really care and say how much they love their jobs.”

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.

People felt staff supported them with their health and well-being needs. For example, one person told us staff would go with them if they needed to attend any hospital appointments. Another person told us how staff had encouraged them to socialise and this had improved their well-being. They said, “When I first came here, I liked to have my meal in my room. But on Christmas day staff encouraged me to try eating dinner with everyone else and since then, I just haven’t looked back, and I sit with the other ladies every day.”

Records showed staff arranged for the visiting community matron or GP to see people and review their health needs with them whenever this was needed. This helped support people to maintain their health.

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 andconsistent, or that they met both clinical expectations and the expectations of people themselves.

Records did not always show people’s care was monitored. For example, people’s food and fluid charts had gaps where no meals had been recorded or had only recorded very low levels of fluids taken. There were no explanations or whether more attempts were needed to ensure people were taking adequate food and fluids. One person required repositioning to help relieve pressure sores. However, records did not demonstrate this had been done in line with the frequency identified in their care plan and had showed significant periods of time with no repositioning. The provider was therefore not able to always show how they monitored people’s care to improve it. This shortfall had not been effectively identified through the provider’s audits and reviews of records.

Other monitoring of people’s healthcare needs was in place. For example, one person told us, “At the beginning of each month I have my blood pressure taken and weight.”

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

We observed staff checked with people how they could help them and sought their consent. For example, we observed staff approaching people in their rooms, they respectfully knocked on bedroom doors before entering and used the person’s name before checking with them what they needed. This helped to uphold people’s rights around consent.