Bromley Road Hospital

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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

This means we looked for evidence that the hospital met people’s needs.

At our last assessment we rated this key question good. At this inspection, the rating has remained the same.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

We scored this quality statement 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff demonstrated a good understanding of the people they supported. They were able to describe individuals' personal histories, preferences, strengths and recovery goals. Care and support were adapted to meet people's changing needs, and patients had access to a range of therapeutic, educational and community-based opportunities that reflected their individual interests and rehabilitation objectives. Relatives told us staff understood the needs of their family members and adapted support accordingly.

Staff worked flexibly with patients to support their recovery and rehabilitation goals. Patients accessed a range of opportunities including community activities, recovery-focused interventions and skills development programmes designed to support their individual progress and longer-term goals. For example, care plans included goals relating to developing independent living skills, progressing towards supported or independent accommodation, increasing unescorted community access, accessing education, voluntary work or employment opportunities, improving social and family relationships, managing medication independently, and developing the confidence and practical skills required for successful discharge.

Staff supported patients to work towards these goals through personalised rehabilitation programmes, travel training, budgeting and shopping activities, vocational support and community engagement. Care and treatment remained focused on supporting people to achieve goals that were important to them.

We scored this quality statement 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Admission pathways, MDT working and rehabilitation planning supported continuity of care. The service worked with commissioners, community teams and external agencies to facilitate progression and discharge planning.

Medical staff, psychology, nursing and wider professionals worked collaboratively to coordinate care and support people’s progress through the rehabilitation pathway.

Some patients and relatives reported concerns regarding communication about discharge planning and future placements. Leaders demonstrated awareness of these concerns and reflected on feedback received from family members regarding communication about proposed transfers to other services, recognising that earlier engagement with patients and their families would have supported a better experience.

Patients were supported to maintain relationships that were important to them. Staff facilitated regular contact with family members and friends through visits, telephone calls, video calls and community leave where appropriate. Relatives told us they were generally kept informed about their family member's progress and were encouraged to contribute to care and discharge planning discussions.

Staff supported patients to access a range of community-based activities that reflected their interests, preferences and rehabilitation goals. Examples included attending walking groups, sports activities, shopping trips, educational opportunities, cafes and social outings. These opportunities supported people to develop confidence, increase independence and maintain meaningful connections with their local communities.

Staff demonstrated an awareness of patients' diverse cultural, religious and spiritual needs. Care plans included information about people's protected characteristics, personal preferences and beliefs where relevant. Patients were supported to observe religious practices, access faith leaders, celebrate cultural events, maintain important routines, and access food that reflected their cultural or religious requirements. Staff sought to provide care that respected people's identity, values and individual circumstances.

We scored this quality statement 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made sure patients could access information on treatment, local service, their rights and how to complain. Any information could be translated for patients into a language they understood. If needed, interpreters could be

booked to attend meetings. Managers also made sure staff and patients could get help from interpreters or signers

when needed

Patients told us they received a welcome pack on admission and were supported to orientate themselves to the service.

The service provided accurate, up-to-date information in formats tailored to individual needs. Patients were able to access information about their treatment, local services, and their rights.

Information governance systems were in place to maintain the confidentiality of patient records. All staff had completed training in information governance and understood their responsibilities in handling sensitive information. At the time of the

assessment, Information Governance, General Data Protection Regulation (IG, GDPR ) training compliance rate was 94.3%

We scored this quality statement 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, [IL1] treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Mechanisms existed to gather patient feedback, including community meetings, ongoing engagement with patients and complaints processes. Community meetings provided patients with opportunities to raise concerns, share suggestions and contributes to decision about ward. Topics discussed included activities and community outings and leave arrangements.

Patients and relatives were able to raise concerns and provide feedback about their experiences of care. Records showed that complaints were investigated and reviewed through established governance processes, and leaders demonstrated awareness of the issues raised by patients and relatives.

Patients and relatives generally felt able to provide feedback and raise concerns. Patients were encouraged to contribute ideas for improvements and were provided with feedback on actions taken in response to issues raised.

Staff understood the policy on complaints and knew how to handle them.

Complaints were investigated and learning identified. The learning was then discussed by staff during routine staff meetings

We scored this quality statement 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The service operated clear admission criteria which were consistently applied. Referral, assessment and admission processes considered individual needs and protected characteristics, and staff made reasonable adjustments where required to support equitable access to care. Patients admitted to the service were appropriate for the rehabilitation model and could be safely supported within the service environment.

The service maintained access to appropriate medical support. There was now adequate medical cover during the day and overnight, with formal arrangements in place to ensure patients could access medical advice and treatment when required. Staff told us a doctor could attend promptly in an emergency, demonstrating improved arrangements since the previous assessment

Patients were able to access a range of rehabilitation opportunities designed to support recovery and community reintegration. This included community-based activities, recovery-focused programmes and opportunities to develop skills that supported greater independence and progression towards less restrictive settings.

We scored this quality statement 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff demonstrated an understanding of patients' individual needs, backgrounds and circumstances and adapted support accordingly. Care planning reflected patients' psychological, physical and social needs, with access to therapeutic interventions, rehabilitation activities and community opportunities tailored to individual recovery goals. Patients were able to access support that reflected their personal needs and circumstances.

Feedback from patients and relatives was generally positive. Relatives described good experiences of care and spoke positively about the progress people had made during admission. Patients and carers described improvements in wellbeing, independence and progress towards rehabilitation goals, supported through structured treatment and recovery programmes.

We scored this quality statement 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Recovery and rehabilitation planning were embedded within multidisciplinary practice and demonstrated a commitment to supporting longer-term independence and community reintegration.

The service maintained a strong focus on recovery, rehabilitation and community discharge.

Patients were supported to develop skills, engage with community resources and prepare for future transitions. They had access to rehabilitation opportunities designed to build confidence, resilience and the practical skills required for successful community living. MDT discussions and effective partnership working supported discharge planning and recovery-focused care.

We observed multidisciplinary meetings where staff reviewed patients' progress towards rehabilitation goals, discussed graduated leave arrangements and considered the support required to promote safe and successful transitions. For example, staff discussed plans for family visits involving young children, carefully considering risks, safeguarding arrangements and measures needed to support positive family contact while maintaining safety.

Discussions demonstrated a person-centred approach, balancing recovery goals, family relationships and individual risks. Staff worked collaboratively to identify barriers to progress and develop plans that supported patients to achieve greater independence and move towards less restrictive environments.

Patients told us they were involved in discussions about their future goals and valued opportunities to develop skills and confidence in preparation for discharge.

Relatives told us staff generally supported patients to maintain important family relationships and involved them in discussions about future plans and discharge arrangements with consent.

We observed staff discussing patients' individual goals, family circumstances and community support needs during multi-disciplinary Team (MDT) meetings, demonstrating a proactive and collaborative approach to planning for future transitions.