Bradley Complex Care

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

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

Good: This meant people were supported and treated with dignity and respect; and involved as partners in their care. Staff treated people with compassion and kindness. They respected privacy and dignity. They understood the individual needs of people and supported them to understand and manage their care, treatment or condition. Staff involved people in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately.

We have not awarded this service a score for Caring.

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

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

During our site visit we undertook short observational framework for inspection (SOFI) observations during some group activities and observed a medication round. These observations showed staff attitudes and behaviours when interacting with people were discreet, respectful and responsive, providing them with help, emotional support and advice at the time they needed it.

Staff supported people to understand and manage their care, treatment or condition, whether this was assistance with aspects of daily living, activities, assistance with medication or access to the community and external services.

Staff we spoke with spoke compassionately and knowledgeably about the people they supported and the 3 people with spoke with during our inspection told us staff treated them well and behaved appropriately towards them. We spoke with the relatives of 3 people who told us we “get on well with the staff and see some regular staff quite often”, “staff are friendly and competent when he comes on leave” and the “physical care coordinator has been very good”. Relatives did also raise some concerns regarding some staff interactions telling us when they visited or when they communicated via video call some staff did not interact with their relative. Relatives also raised concerns about some staff not being able to meet their relatives needs due to cultural differences and language barriers.

We spoke with 4 external partners who all told us that the people they supported had good relationships with the team and stated, “the hospital team have built up a rapport with the individual providing compassionate care.”. Additionally, they told us that the therapy team involved had also built good working relationships and told us, “The hospital does allow for additional meetings at our request and includes family too in all meetings to support the voice of the person.”

Staff we spoke with understood the individual needs of people, including their personal, cultural, social and religious needs. This was reflected in the 6 care records that we reviewed.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards people without fear of the consequences. We saw evidence that the ward took appropriate action when concerns were raised.

We scored the service as 3. The evidence showed a good standard. The service 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.

The service could support people’s additional needs such as mobility needs by ensuring all people could access the premises and by meeting specific communication needs with the use of communication aids, were appropriate.

Staff ensured that people could obtain information on treatments, local services, patients’ rights and how to complain.

Information was provided in a form accessible to the patient group and people we spoke with told us they were involved in meetings and completed a meeting feedback sheet and people confirmed they had access to advocacy. The service told us, we saw this as part of care planning and observed communications regarding the use of communication aids, use of social stories and Makaton to support communication and provide information to people.

People had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerance's.

Staff encouraged and developed ways for people to access things that were important to them, for example, cultural and spiritual support. The service celebrated national holidays and would make this relevant to the cultures, values and customs of the patient group.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

The feedback we gained from people, their families and external partners indicated that people had access to activities and community meetings. People were also supported to maintain relationships with their family.

During our assessment we gained feedback from 19 team members, including the hospital manager. All staff had a good understanding of the Mental Capacity Act; they supported people to communicate and make informed decisions about their care.

The service linked in with external teams to support people to maintain independence and control. We looked at 6 care and treatment records which had detailed positive behaviour support plans in place. People had hospital passports called ‘My Life’ forms which were emailed to the learning disabilities nurse link at the hospital, and this supported the person if they were admitted to hospital. The service had also created an external healthcare appointment form which was completed with all relevant information to ensure that any actions taken, or follow-up appointments were captured and assured more comprehensive notes.

We received feedback from the independent advocacy service regarding observed good practice when a person using the service presented as unsettled and verbally and physically abusive towards staff. They observed this was dealt with using verbal de-escalation which settled the person and enabled them to return to their apartment using least restrictive practices.

We scored the service as 3. The evidence showed a good standard. The service 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.

The hospital was committed to reducing the use of restraint and restrictive practices, promoting human rights and person-centered approaches. The provider was a certified organisation and Restraint Reduction Network approved. Staff used de-escalation techniques to reduce the need for physical interventions when a person’s behaviours became heightened and completed training in conflict resolution, reducing conflict situations and behaviours of concern and behavioural support training all above 95% compliance.

The wards responded to physical health by using recognised rating scales to assess and record severity and outcomes such as National Early Warning Score (NEWS) to identify acute deterioration, including sepsis, however we found the forms did not easily identify the person. Following our inspection the service amended these forms to ensure they included dates, times, name and date of birth of the patient. People were referred to external services such as dentistry, community health and to speech and language therapy, as required.

The hospital spoke about good collaborative work with the GP and general hospital. The service had developed a link with a learning disability nurse at the hospital, and this supported people through A&E as quickly as possible. Meetings had also been held with the GP surgery to discuss the management of monthly prescriptions to ensure a response to people’s immediate needs.

We scored the service as 2. The evidence showed some shortfalls. Not all staff felt the service cared about or promoted their wellbeing. However, staff did feel enabled to deliver person-centred care.

During our inspection we spoke with 19 members of the team, including 10 support workers and not all staff we spoke with felt respected, supported and valued by the hospital. Some staff told us that they had concerns about raising issues in supervision and with the freedom to speak up for fear of reprisal. We spoke with the management team regarding this; it became apparent that there was a drive to ensure that any issues were picked up during supervision and action taken so that staff did not have to repeatedly raise concerns. Supervision training was in place and this included looking at examples of good supervision and appraisals. However, the organisations Clinical Supervision policy was out of date with a date of review, March 2025.

Some staff informed us that they were not paid for time off following injuries that were sustained at work. The hospital informed us this was not correct but there was a process that staff had to follow to ensure this payment was made. We reviewed this procedure which outlined the process and the hospital assured us if the correct procedure were followed this would be paid. We also saw in minutes that this was discussed in the staff team meeting in September 2025 and the provider presented evidence following the inspection which showed that this information had been revisited with the staff team.

Staff spoke positively about their role in terms of the support they provided for people, and they spoke with genuine compassion and kindness regarding the people which they supported. In the most recent staff survey questions such as patient safety, effective training and the organisations commitment to ethical care delivery and professional conduct scored 80-93%. Staff comments regarding what the organisation was doing well included “implementing changes that will benefit the service and the patients”, “trying to improve the quality of life for service users” and “supporting patients and providing a high level of care. promoting independence and a good quality of life”.

The service employed a wellbeing and compliance lead who we spoke with and who told us about several initiatives for staff wellbeing such as the refurbishment of the staff room including a new 3-piece suite, a massage chair and coffee machine and the refurbishment of the multi-faith room, both rooms we observed during our tour of the environment. The service had a weekly shopping bag raffle for staff and monthly staff of the month awards where staff received an extra day’s leave. We saw evidence in a wellbeing folder of pictures of celebrations such as Black history month, Halloween and Christmas.

Staff appraisals included conversations about career development and how it could be supported. Some staff we spoke with had been supported by the provider to develop in their career and supported access to apprenticeships and the nurse associate role.