SEL Mind – Bromley MindCare

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• 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 service met people’s needs.

We did not assess all the quality statements within this key question. We did not identify concerns relating to these areas which we judged as being met at our last inspection.

This key question has been rated outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was an exceptional person-centred culture, where staff worked with people and their relatives to understand how best to support and empower them. People were central of everything staff did to ensure their needs and wishes were understood and respected and support was appropriate to help people live fulfilled lives.

For example, the registered manager told us how they helped one person to seek suitable accommodation as it was their wish not to be moved into a residential care setting. They helped the person to be able to continue to access the service as the person required support to transition and settle into their new home. Staff also supported the person to move into their new home and supported them with public transport journeys showing the person routes to take when accessing other health and social care services as the area was new to them. The registered manager explained that they also supported the person to seek extra funding for additional support as their dementia was in decline and felt it was imperative that the person was supported as much as possible to retain their independence. The registered manager also supported the person to manage their finances and to get an Oyster card to continue to use public transport as loosing items such as cash was an issue for them.

Staff were exceptional at ensuring people were at the centre of their care and support choices. Staff recognised people as individuals and identified and supported their specific needs and wishes. Care plans reflected people’s individual preferences, life histories and wishes. A relative told us, “[Registered manager] knows we provide [loved one] with all their care needs, so she is always on the lookout for support that might help us. I think their matching service is very good and [staff] has been the proof of that. [Loved one] would probably be in a care home by now without Mind, which [loved one] would hate. Between us, [loved one] is content and happy.” A second person told us, “The carer from Mind that comes to support [loved one] has been a lifeline, because [loved ones] other care has fallen short of meeting [loved ones] current needs. The Mind visits really help with [loved ones] mental health as [loved one] really feels isolated most of the time and the other agency carers are in and out in a flash.”

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People were genuinely respected and valued as individuals and were supported and empowered by staff as partners in their care. There were robust procedures in place to make it easy for people to share feedback, ideas or raise complaints about their care and support. Staff steered the culture of person led involvement where people were fully engaged in decisions about their care and support.

The registered manager gave examples of the creative ways they worked to involve people to drive decisions about their person centred care. The registered manager spoke of the collaboration work they had done for people and their relatives/carers to have a voice, be heard and felt listened to. They advised that a local MP arranged for them, people using the service and their carers to attend a parliament tour. The registered manager also arranged for people and their relatives/carers to attend and speak at a conference for the ‘memory services national accreditation programme’, by the Royal College of Psychiatrists. They told us, “People wanted to talk about changing perceptions from the onset of a diagnosis as well as societies idea of dementia, testing and feeling like they have already failed. People want a way to diagnose without feeling as if they will fail a test, also misdiagnosis and the time it takes to get a diagnosis. They also felt strongly about having regular reviews of medication and the perception of dementia, feeling like there is no hope, it’s a death sentence. They really wanted to change this.”

Feedback from people and their relatives led to clear actions taken by staff to improve services. People and their relatives expressed confidence in raising complaints and being listened to. A person told us, “There has never been cause to complain about anything they [staff] do and because of the bi-monthly calls to check on progress, I am confident [loved one] is in good hands.” Another person commented, “If it is even reported back to the office that [staff] has noticed I am very anxious about a certain situation, I will get a care call to make sure that I am ok. They really are wonderful people.”

The provider was exceptional at ensuring people could access the care, support and treatment they need when they needed it.

Staff recognised the importance of people being able to access and use services. Staff practice exercised and followed legislation to ensure people’s rights were upheld, for their care and support to be needs led and equality based. Staff excelled in identifying when people required additional or specialist support from other agencies and supported them to access these. For example, the registered manager told us of the work they undertook to ensure people could access the government ‘household fund’ paid out by local authorities. They told us how they fought for accessibility in receiving the fund as many people they supported were living with dementia and were unable to use an ecard. They explained how they worked with the local authority so people could get a physical card for them the use in stores.

People told us of the work staff undertook with them and on their behalf to ensure equity in access. A person said, “This service keeps my head above water. We lost it (service) for a while when the council stopped paying for it and we didn’t have enough funds to cover it. We were already living on the minimum you are supposed to live on. Mind fought our case for us and got it reinstated, which I am eternally grateful for. Mind really came up trumps when we lost the funding for the respite call. They fought our case and got the funding back for us. I was and still am so very grateful. It allows me to have an awayday with a friend doing normal things which reduce the stress levels, albeit temporarily.”

The registered manager expressed the difficulties some people face when applying for a disability badge. They explained that they had worked with the ‘blue badge’ team to highlight the different effects of dementia and how not all disabilities involve mobility problems and needs. They told us of the inequalities people, and their carers may face and how they are working to combat this.

The registered manger told us of the pressures informal carers faced when supporting and caring for loved ones living with dementia. In recognition and support of this they told us they had arranged for an informal carers training which supported their well-being. They said that this was very popular and so they had arranged for this to be held again next month to accommodate more attendees. They said, “We have also developed a ‘self-care’ tool kit for carers recognising the difficulties they faced and in recognition of all the work and support they provided.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care and support in response to this. There was a strong, visible person-centred culture within the service.

The registered manager and staff promoted a culture of empowering people to live their life as they chose. Staff supported people regardless of their preferences and actively went above and beyond to ensure they had equity in experience. For example, the registered manager told us of the collaboration work they did with a top London attraction. They informed us that a group of people using the service, and their carers had a day out to the attraction and provided valuable feedback to the London attraction on how accessible the attraction was and how they could make it more accessible for people. The London attractions commitment to becoming more dementia-friendly aligned with the broader initiative of ‘dementia friendly London’ recognising the importance of engaging with those directly impacted.

The registered manager also told us of the collaboration with arranging for people and their carers to go to a formula 1 race day, again ensuring and feeding back to the event on how to make the experience accessible for all and dementia friendly.

The registered manager told us of the work they did with Mind YODA (Young Onset Dementia Activists group). They told us people in the group supported each other and shared experiences, such as dancing, arts and craft, singing and outings. They also spoke of their involvement in fundraising and raising awareness of young onset dementia. The registered manager and members of the group had also appeared on national TV talking about the rise of early onset dementia and the work YODA did to support and empower people.

The registered manager also told us of the work they did with other groups within the organisation who are also most likely to experience inequality in experience or outcomes. These included an LGBTQIA+ peer support group ‘Queer Minds’. They explained that this group was open to all members of the LGBTQIA+ community and was a great opportunity for people to meet others, share their experiences and engage in discussions and activities around topics which had included depression and anxiety, support networks, neurodivergence, and coping skills for trauma. The registered manager told us they were part of an inclusion group that meets regularly.They informed us that they recently discussed Black Pride and looked at the service for what they could do better regarding data collection and how the service could support people and young people with early on set dementia.

Staff actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care and support in response to this. People shared examples where staff had gone the extra mile to ensure people were as independent as possible. A relative said, “They [staff] are very confident about suggesting things [loved one] might like to do even though [loved one] is bedbound now. I think that shows they care. Nothing is too much trouble for them and often, they think of it first.”

The registered manager spoke of the collaboration work they had done for people and their relatives/carers to have a voice, be heard and felt listened to. They advised that a local MP arranged for them, people using the service and their carers to attend a parliament tour. The registered manager also arranged for people and their relatives/carers to attend and speak at a conference for the ‘memory services national accreditation programme’, by the Royal College of Psychiatrists. They told us, “People wanted to talk about changing perceptions from the onset of a diagnosis as well as societies idea of dementia, testing and feeling like they have already failed. People want a way to diagnose without feeling as if they will fail a test, also misdiagnosis and the time it takes to get a diagnosis. They also felt strongly about having regular reviews of medication and the perception of dementia, feeling like there is no hope, it’s a death sentence. They really wanted to change this."

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.