Bramble Home Care Limited

On this page

• 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

Responsive – this means we looked for evidence that the provider met people’s needs.

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

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

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 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.

We saw care records were completed to an exceptional standard and included person-centred details which were unique to each person. It was evident care records had been completed individually and focused on their care and support needs. People’s risks had been clearly identified and ways to prevent risks was recorded and easily understood. Care records contained a very detailed personal history of each person and reflected people’s unique lives. Care records contained quotes from people about things which were important to them. For example, one care record had a quote from the person, “I like to sit in my armchair and watch the boats in the harbour.”

We spoke to 1 staff member who told us, “I really like Bramble Homecare because it is more person-led and people can have care when they want it, it's not regimented.” People told us there were person-centred interactions between them and staff members. One person told us, “I am very happy. I have a lovely view, and I sit and make my own models and the staff that come and see me give me lovely company. We talk about what’s important to me and they make me feel special.” A relative told us, “What makes me the happiest is that if these carers put a smile on [relative] face, then I’m happy. If they smile, I smile.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People told us they felt the service understood their health and social care needs and the local community. The service operated in some very small villages and remote areas, and people had lived in these communities their whole lives. One person told us, “I’m very happy with the care that I receive. They completely understand me and how I like to live. They support me with things, so I have more independence.” A relative told us, “They have integrated with the family well, what is really nice is that the staff will always ask if they can do anything differently.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff told us they understood data protection principles and how data about people should be recorded, stored securely and only shared if the person consents. One member of staff told us, “I had training before I started which was face-to-face. I would share information with the office staff if I felt it was significant. I would also make the family aware of any concerns. If a person told me something and asked me not to pass it on, I would explain to them I would need to tell the office and why.” There were policies in place and in line with current best practice guidance around the Accessible Information Standard and General Data Protection Regulations.

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.

The provider had introduced a system called ‘touchpoint’ which was a formal process whereby people were contacted at specific times when they joined the service to give feedback about their experience of the service. The system involved strict timescales and gave people space and time to share any concerns or raise any suggestions with the managers. However, we found people could not describe this was happening. People knew how to raise a concern or complaint. They told us they would feel confident to do so and they felt they would be taken seriously. One person told us, “Everyone in the office has always taken me quite seriously. They’re very polite. They listen to me well.” Relatives did not give consistently positive feedback on how they felt involved and listened to. A relative told us, “Recently we had mud on our carpet which was quite frustrating. I raised this, but I think the manager could be more transparent about actions taken after a complaint is made.” Another relative told us, “There has never been any spot checks, and I’ve not ever given any feedback.” The provider told us some complaints about feedback before the new system was implemented and the management team were working on ensuring everyone received communication in line with the new system.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

We saw evidence the service offered flexibility, and people could access support when they wanted it. People were encouraged to contact the office if they needed support with attending appointments. We saw evidence the service responded to emergencies. The manager told us, “One package was originally commissioned for support from 1 staff member, but within the first visit we could tell they clearly needed 2 staff. This was due to the pre-assessment completed by the hospital and brokerage. This prompted us to create the hospital discharge form. We must accommodate people in very immediate situations and having the support of the provider and the other office managers are just the best - I couldn't do anything without them. We go to the hospital and check if people's needs are in line with what we've been told. I get as much information as possible. I check about the OT (occupational therapy) plan, equipment, etc. I'm trying to raise the standards of how discharges happen to prevent unsafe discharges. It's been working so well. I can even look ahead and see if a person deteriorates, do we have staff provision available to ensure we can continue to meet their needs? We had 1 person who had discrepancies in their care plans which we addressed whilst the person was still in hospital. This allowed us to ensure the equipment was in place and we had the right staff provision available.

The service had emergency protocols and contained information around what individuals and staff should do in an emergency or out of hours. For example, the provider had an on-call rota.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

We saw evidence staff and leaders understood the potential for discrimination and inequality for people who used the service may be faced with. Managers told us how they advocated on people’s behalf to help tackle discrimination. The manager told us, “The people we support, some have mental health needs. I say to my staff, for the person, if they don't like people wearing uniforms, go in your own clothes. I encourage staff to do what they can to reduce the stigma. Where we’ve identified concerns around terminology in daily notes, I did a mini teaching session with staff at the next staff meeting and sent an email out to all staff about the importance of using person-centred words.” All staff had training to help them understand equality and address discrimination.

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.

The service was not supporting anyone with end-of-life care at the time of the inspection, however care records showed people’s end of life care needs were considered. The manager told us, “When we've had end-of-life clients before we've had amazing feedback from people. We strive to have the highest standards of care and promote holistic care.”