Bromson Hill Care Home

On this page

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

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were supported and treated with dignity and respect and involved as partners in their care.

This service scored 70 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

People told us staff were kind and treated them well. Their comments included, “They are genuinely nice people,” and “The staff are always very respectful.”

Staff at all levels spoke positively about their roles and demonstrated genuine compassion. Comments included, “Caring for the people here is an honour for me,” and “I like interacting with them- I like to see them laugh.” The registered manager described the staff team as’ kind, patient and thoughtful.’ The registered manager told they were proud of the improvements they had made in the home.

We saw staff were thoughtful and caring and people’s responses and body language indicated they felt comfortable in the company of staff. A member of staff walked through the communal lounge and noticed a person appeared a bit cold. When the person confirmed they were feeling chilly, the staff member immediately went to the person’s bedroom and returned with a cardigan for them. One person repeatedly called out to staff who consistently responded with patience and good humour.

A healthcare professional who visited the home often told us, “You can feel the love here, they want the best for people, and you can see it.”
 

The provider 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.

Staff demonstrated a good understanding of people's individual needs, preferences and interests and used this knowledge to provide personalised support.

Relatives spoke positively about the efforts staff made to get to know people as individuals. One relative told us, “They have made a big effort to get to know her.” Another said, “[Name] plays chess here with a care worker, they know he likes that.”

We were told 1 person enjoyed gardening and we saw a staff member sitting with the person reading a gardening book. When another person demonstrated some anxiety and a staff member responded by talking with them about an expected visit from their family.

People's religious and spiritual needs were respected. For example, one person had religious artefacts in their bedroom, and we observed a staff member reading the Bible with them.

Improvements to care records was needed to support the delivery of person-centred care. Care records did not always contain detailed information about people's individual choices, preferences and wishes. This meant the delivery of personalised care and support relied on staff knowledge rather than being clearly recorded to support consistent care delivery.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

People were supported to make some choices about their daily lives and staff generally respected their decisions and preferences. However, opportunities for people to exercise choice and control were not consistently promoted across all aspects of the service.

For example, kitchen records identified six people who required a pureed diet. Whilst other people were routinely offered a choice of two meal options, those requiring a pureed diet were not offered the same opportunity to choose and all received the same meal. Similarly, all people dining in the communal dining room were provided with the same fruit drink without being offered an alternative or given information about the available options. This reduced people's ability to make decisions about what they wished to eat and drink.

In addition, when people had not eaten their meal, plates were sometimes removed without staff exploring the reasons why, encouraging the person to continue eating, or offering an alternative meal choice. This meant opportunities to understand and respond to individual preferences were missed.

People were not always actively involved in planning their care or making decisions about the support they received. One person told us, “Not sure I have any choice, I just sit here.” Another person said, “I was asked if I wanted it (last week), but I am still waiting.” These comments suggested people did not consistently experience autonomy or control over decisions affecting their lives.

There were positive examples of staff supporting people's independence and respecting their choices. A designated activities staff member spent time engaging with people who remained in their bedrooms as well as those using communal areas, helping to ensure opportunities for meaningful occupation were available to everyone. During our assessment, people were offered opportunities to participate in group activities and spend time outdoors in the garden. Where people chose not to participate, staff respected their decisions without pressure.

Choice was promoted in relation to social relationships and visiting arrangements. Relatives and friends were welcomed throughout the day, and people were able to decide whether they wished to spend time with visitors in the privacy of their own rooms or in communal areas.

Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

People and their relatives told us staff responded promptly when support was needed. One person said, “I have a call bell on my wall, I can just reach it. I use it a fair bit, but they come in 4 minutes usually.” Another person described their call bell as “My lifeline” and told us, “When I ring, they come quite quickly.” Relatives shared similar feedback, with 1 commenting, “She has a call bell…they are always quick when I am here.”

The registered manager reviewed staff response times to call bells and was planning to extend this responsibility to other senior staff to ensure effective oversight in their absence.

Throughout the inspection, staff maintained a visible presence in communal areas and were attentive to people's needs. This enabled them to identify when support was required and respond without delay. People appeared comfortable seeking assistance and were observed receiving timely support when needed.

Staff responded to changes in people's emotional wellbeing and safety needs. Where people experienced anxiety, distress or difficulties with mobility, staff acted quickly to provide reassurance and practical support. For example, a staff member remained with a person who was at high risk of falls and immediately sought assistance when the person attempted to mobilise without their walking aid. When the person became distressed, staff assisted them to a quieter area by an open window and spent time talking with them until they became calmer and more relaxed.
 

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The provider demonstrated a positive and supportive culture where staff wellbeing was valued and promoted. Staff told us they felt supported by the registered manager and were able to access help and guidance whenever needed. Staff described the registered manager as approachable and understanding.

Staff told us the service offered flexibility around working arrangements, particularly where they needed time to attend personal healthcare appointments or manage other personal commitments. Whilst staff were sometimes asked whether they could cover shifts during periods of absence, they reported this was always voluntary and they never felt pressured to work additional hours.

The provider and registered manager had considered staff wellbeing. One staff member described how they had received significant support during a period of ill health, including regular contact and arrangements to facilitate a gradual return to work.

The registered manager spoke about the importance of treating staff fairly and with kindness, saying, “It is important to me to treat staff well.” Staff’s experiences reflected this approach. One staff member told us, “She is always really, really kind and helpful, not only for me, for all the staff. We can go to her about anything, and she will listen and care for us.”

The provider had also introduced initiatives to promote staff wellbeing and recognise contributions. Staff told us they were regularly provided with meals, treats and rewards as a token of appreciation. In addition, a monthly staff recognition scheme celebrated individuals who had demonstrated hard work and dedication. The most recent recipient told us the award made them feel appreciated and proud of their contribution.