Bramble Home Care Limited

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 assessment we rated this key question Good. At this assessment the rating has remained Good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (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.

The provider and manager carried out regular reviews of people’s needs. The service had clear processes for oversight of reviews. We reviewed the provider’s weekly report in which all data from care records was highlighted including which areas of the care records were due for review.

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.

Staff told us they were aware of people’s specific dietary needs and explained how they met those needs. One staff member told us, “We had someone who was end of life who had trouble swallowing. When she deteriorated, we called the district nurses and they assessed her. When she started having difficulty swallowing, we introduced food pouches, yoghurts, etc. We wouldn't give any hard foods.” Another staff member told us, “Some clients can have allergies. During my induction I learnt what common allergens are and how to recognise allergic reactions. Some people are on softer diets because of difficulty swallowing.” The staff member further explained how they supported people to manage their diabetic diet and those people who required a soft diet.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The manager facilitated good information sharing and collaboration with external health partners. The manager told us, “We have clients with stoma and catheter care needs, and I arranged training recently from a stoma nurse from the local large hospital to come in and deliver training. I'm arranging catheter training and more detailed skin integrity training. Most staff have their Level 3 first aid training, which is additional to the induction training. This is an all-day training session. The District Nurses we work with completes insulin administration and pressure wound care. We will support them with arranging visits, so staff and nurses are at a person’s home at the same time. I will send messages from the nurses which they want to share with staff. For example, there was a nurse who fed back staff were applying too much barrier cream which I informed the staff about and I showed them how much barrier cream they need to apply.”

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

We saw evidence staff supported people with promoting healthier living. One staff member told us, “I used to do a shopping visit for 1 person. She'd give us a list and then I’d go shopping for her. There was a time when she just wanted frozen ready meals and we tried to help her choose healthier options such as crumpets for breakfast. She also had unhealthy habits such as smoking and drinking. I would try to gently encourage her to smoke and drink less. I noticed she was lonely, so I introduced her to local group which helps with social visits. This has helped her feel happier.” Another staff member told us, “One person has Parkinson's and we help him with his physio. There is documentation at his home from the physio which guides us. We do this with him before he gets out of bed. During the lunch time visit, we also go for a walk with him to keep him moving. We just go up and down the street.” Feedback from partners was positive. One professional told us, “Carers are very helpful, involved, go the extra mile and try to make a difference.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Managers and care co-ordinators who worked out of the main office kept up to date with concerns around people’s clinical and quality of life outcomes. The manager told us, “I've introduced daily meetings at 10am. This is to ensure everything is handed over, I do the minutes and send them out. We discuss what we are doing for the day, any sickness, any issues with the IT systems, etc. I will delegate some reviews with clients, but I also like to do some myself. If I don't know what's going on I can't support people. If there's ever an issue, and I don't know about it, I can't support my staff and clients. Many months ago, we had a lot of complaints, but this has reduced.” We saw evidence of improved outcomes in care records and records of feedback from people and partner organisations. These showed evidence individuals had been supported to improve their health and quality of life. For example, by providing support with physiotherapy exercises to improve mobility.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us how staff supported them to give their consent before they delivered care and support. People told us, “They always ask for consent” and “Yes, always, they ask me if it’s okay to have a wash or shower.” Relatives told us, “My [relative] doesn’t say much, but often I ask them how everything’s going, I might ask ‘have you had a good wash?’ There was 1 staff member that they didn’t really get on with and since then we have refused to have that carer again” and “They do ask for consent all the time. Staff talk to [relative]. Staff always ask if they are okay and if there is anything they need.” People had their mental capacity assessed and records were kept if a person had lasting power of attorney.