Bradley Complex Care

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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 service met people’s needs.

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

Good: This meant people’s needs were met through good organisation and delivery.

Staff managed beds well. A bed was available when a patient needed one. The design, layout, and furnishings of the hospital supported people’s treatment, privacy and dignity. Staff supported people with activities outside the service, such as work, education and family relationships. The service met the needs of all people – including those with a protected characteristic. Staff helped people with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

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 the service as 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.

As part of our assessment, we used the Quality of life tool (used for inspecting specialist services for people with a learning disability and autistic people). The tool looks at how well people's care plans are delivered in practice.

Our observations and feedback from the team, relatives and external partners supported the delivery of person-centred care.

We reviewed 6 care plans and positive behaviour support plans and found that they included likes and dislikes and clear strategies to deescalate or manage behaviours. The service made every effort to ensure people were at the centre of their care and treatment choices and as a multi-disciplinary team they discussed how to respond to any relevant changes in their needs.

We spoke with the speech and language therapy apprentice and occupational therapist who informed us the team ran individual and group sessions based on people’s individual needs; communication care plans were completed and kept up to date with any reasonable adjustments required. The team also created easy read care plans and completed social stories, which are short, descriptive narratives that help individuals with autism to understand social situation in a clear and appropriate way.

We scored the service as 4. The evidence showed an exceptional standard. The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff told us that people had access to education, tutoring and activities within the hospital environment and in the community. The occupational therapy team had developed a new volunteer roles program and held a vocational 'careers day' for people who used the service. The roles included a resident disc jockey, a painting assistant and a Makaton assistant. People were brought into the career’s day on a one-to-one basis, were supported to complete a volunteering application form and presented with a certificate on appointment to a role.

The service offered weekly group sessions, including arts and crafts group, coffee afternoon targeting goals for socialisation and creative expression, a breakfast club targeting life skills goals, dance fitness for body movement, sensory, emotional regulation and sequencing and in the summer a gardening group was also offered.

The hospital celebrated annual occasions and holidays such as black history month, Halloween and Christmas involving staff and people using the service and we saw evidence of these celebrations in photographs.

The provider also shared examples of collaborative work with the GP, dentists and paramedics. In one example a paramedic had supported the service to take bloods from a person using the service following a best interest meeting, the paramedic visited the service regularly and staff sang songs to calm the person and in another example a dentist visited the service to observe how the person was chewing and sang songs to enable a check of the persons mouth. The service had written protocols regarding how to take bloods, complete physical observations and engage with dentistry for people using the service.

The psychology team were developing sexual safety training to support people’s understanding of sexual misconduct, enabling staff to provide effective psychological support and promote safe access to local communities.

The monthly community meetings were chaired by a person who used the service and enabled all people to attend and express any concerns and requests which were taken to clinical governance meeting.

Staff supported people to maintain contact with their families and carers, they accommodated visits and phone calls for carers and family members and the 2 families we spoke with during our assessment confirmed this.

Staff supported people to access their chosen place of worship within the community.

We scored the service as 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 told us they strived to keep carers, families and commissioners updated about the person’s progress and the service planned friends and family events to support this, to enable families to meet members of the team, ask questions and give feedback. We spoke with 3 families and received feedback from 4 external partners as part of our assessment. Families and external partners raised some concerns regarding communication with the hospital. Information was provided; however, it was not always as timely as people would like and sometimes, they had to make made multiple requests.

During our inspection, we noted that Care Quality Commission (CQC) posters with ratings were displayed. Staff made notifications to external bodies as needed. Information governance systems included confidentiality of patient records. Staff audited records to ensure there were no gaps in record keeping, Mental Health Act documentation or Deprivation of Liberty Safeguards paperwork.

We observed several information posters and leaflets within the hospital. All apartments had a noticeboard which included information about community meetings, how to raise complaints, how to give feedback, safeguarding team and advocacy details. This was provided in an easy-read format. The hospital could provide various forms of information, in different languages if required, larger print and easy read documents.

We reviewed 6 prescription charts and medicines records and 6 care records and saw medicines information provided in an easy read format.

Care records showed that regular contact with other professionals involved in people’s care was documented so communication was maintained throughout the person’s admission.

We scored the service as 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, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

People and their families knew how to complain or raise concerns. People were given the opportunity to provide feedback through a range of diverse ways such as community meetings, verbally to staff or through an independent advocate. People and their relatives were also invited to their independent care reviews and able to express their wishes and needs and provide feedback. The hospital had conducted a Family, Friends and Carers Experience Survey. The results from 2025 were shared with us which showed that 1 person had responded and their overall experience of the service was positive.

Staff we spoke with knew how to handle complaints appropriately.

As part of the assessment, we requested all formal and informal complaints made in the last 12 months. The service recorded 24 formal and informal complaints. One formal complaint was under investigation. No complaints had been referred to the Ombudsman in the last 12 months. The tracker included a summary of the complaint, date of acknowledgement and date of the outcome.

We scored the service as 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.

As of 16 January 2025, the current average length of stay was 47.9 months for the current 11 people who were admitted to the hospital as a long-term rehabilitation placement. There were 3 people with active discharge plans. Managers we spoke with told us there were ongoing challenges regarding discharges into the community and placements that can respond effectively to out-of-hospital care needs.

We saw evidence in care records that staff planned for people’s discharge, involving the ICB, local authorities, and third-sector providers. The service was collaborating with these partners to plan and deliver future fit-for-purpose accommodation within the community. Staff ensured people had access to post-discharge care, for example, S117 aftercare, and future support providers.

We also saw evidence that staff ensured the needs of people with mobility issues were met and made reasonable adjustments for people, if required, and had access to necessary equipment.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital.

We scored the service as 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 within the hospital promoted a culture in which the people using the service felt empowered to give their views. The service worked closely with relatives of people to gain their views and the relatives we spoke with confirmed that they were invited to relevant meetings, including about discharge planning.

Staff were trained in diversity, equality and inclusion and compliance at the time of our assessment was 99%. The service had an equality champion who had completed awareness training and whose role was to ensure people were supported as required.

Equality and diversity was also discussed in community meetings with people using the service and the hospital had links with a police liaison officer who was attending the hospital to discuss hate crimes and spread awareness and understanding with the client group.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

We scored the service as 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, including at the end of their life.

Staff supported people to make decisions about their care and treatment and their future, and this included holding best interest meetings involving relatives, carers and advocates in these meetings to ensure the best decisions were made regarding their future. The service developed social stories to help people understand social situations and expectations.

The 6 care records we reviewed showed personalised care plans to account for the person’s needs, wishes and feelings and people we spoke with told us they were involved in creating these. Relatives told us they were involved in discharge planning. It was important to all involved that discharge planning and plans for placements were effective. Staff ensured all relevant healthcare professionals and other relevant bodies are involved in planning the care and treatment of people with complex needs.