Brookview Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated this key question Requires Improvement. There had been a breach of regulation relating to failing to ensure staff received the necessary training, support development and supervision, for their roles and responsibilities. Including enabling them to obtain further qualifications appropriate to the work they perform.

Improvements were found at this inspection, and the rating has improved to Good. The provider was no longer in breach of this regulation. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People had individual care plans and risk assessments in place which had been developed to meet their current needs. People and other specialist healthcare stakeholders were involved in the initial care needs assessment and periodic review of their care needs where appropriate.
People’s care plans identified their care needs but also referred to people’s individual strengths and ways in which their control and independence could be supported and encouraged. Where appropriate to an individual’s circumstances, their care plan included rehabilitation support.
People’s healthcare needs were assessed and detailed in their care plans. People were supported to engage in community healthcare services, as well as more specialist healthcare services, to ensure their health care needs were met.
People’s assessments included details of their communication needs. People’s care plans also detailed when changes in people’s physical presentation, or emotional state, may indicate a deterioration in their health or wellbeing.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.
People’s care needs were detailed in their care plans, including guidance on how their specific needs were to be met.
People were supported to eat and drink enough, and the overall experience in the dining area had improved. For example, a person told us, “I like the fish and chips on Fridays, but all the food is nice here too.”
The manager had introduced a ‘safety pause’ prior to mealtimes. This was a structured period of a few minutes when care staff gathered to discuss the needs of the people they were about to assist in the dining room. This included reminders about anyone who was on a specialised diet, anyone who needed to be supported to eat more, the actions to take should anyone appear to choke on food, and the importance of accurately recording in the care notes what each person ate and drank. This helped ensure people were supported safely with their meals.
Improvements had been made in respect of the completion of people’s care notes about their daily nutritional and fluid intakes, and the manager recognised this was an issue which staff sometimes needed to be reminded about. People were regularly weighed and appropriate action taken to boost a person’s food and calorie intake if a person was observed to be losing weight unexpectedly.
People generally received care, treatment and support which was evidence-based and in line with good practice standards.

The provider did not always work well with other teams and services to support people. External health care teams were not always confident their guidance and advice about people’s health care needs was always implemented in a timely way.
For example, an external healthcare professional told us previous changes in manager, nursing, and senior care staff at the care home had led to a lack of consistency. This meant there had been some occasions when some staff did not always fully understand a person’s current health care needs when meeting with the external healthcare team to discuss changes to their individual care plan.
An external healthcare professional told us, “There are some members of the care home team who know our service well and how to work with us, but this can be variable and continuity cannot be relied upon.” They also told us, “The care home's engagement with the proactive care aspects of our service (eg; long term condition reviews) can also be variable, with information we have requested having to be chased.”
The provider had recently appointed a clinical deputy manager at the care home to address issues of healthcare consistency and increase support for the provider’s qualified nursing staff. However, this was a relatively new appointment and so any expected improvements had not yet been fully embedded.
The provider had electronic care record systems in place, and the manager had acted to ensure staff completed people’s care records in an accurate and timely way. This improvement was still in the process of being embedded at the care home, with the aim of ensuring a more joined up, consistent approach to delivering safe and effective care to people in line with their individually assessed needs and preferences.
Staff had access to the care plan and risk assessment information they needed to appropriately assess, plan and deliver people’s care, treatment and support. People’s care plans were available for care staff to access using the provider’s electronic care records system and handheld electronic devices.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were encouraged and supported to make decisions about their own care needs by staff who understood their complex needs and preferences. Staff encouraged and supported people to make healthier choices to help promote and maintain their health and wellbeing but were also mindful the person had the final say on decisions relating to their care.
The provider’s staff regularly monitored people’s health and supported people to access external primary healthcare support from GPs etc, as well as specialist hospital support when needed.

The provider routinely monitored people’s care and treatment to continuously improve it. They aimed to ensure care outcomes were positive and consistent, and met both clinical expectations and the expectations of people themselves.
This was an area which had improved at the care home since our last inspection. People told us they experienced positive outcomes from living in the care home.
More effective approaches to monitor people’s care and treatment and their individual outcomes were now in place. For example, a person’s relative told us, “Everything is fine. Staff are friendly and someone from our family visits there most days. We are satisfied with [person’s] treatment and, most important of all, my [relative] is happy there.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
Staff supported people to exercise their rights. Staff encouraged people to make decisions about aspects of their daily care routines, and staff obtained consent from the person before supporting them with personal care tasks.
People’s care plans contained assessments of their individual capacity to consent to specific decisions about their care. Where people were unable to meaningfully consent, appropriate best interest decisions were made and recorded in their care plans.