Brailsford House

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

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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed before they came to live at the service to ensure staff would be able to meet their needs and keep them safe. With the involvement of people, or their relatives, this information was used to create care plans, which were updated during regular reviews or when people’s support needs changed. This ensured staff had access to up-to-date information and could continue to provide people with appropriate support which reflected their assessed needs and promoted their health and wellbeing. A relative told us, “They [staff] are keen to help and their communication is good. They keep us informed.”

Leaders ensured people were involved in planning their care, so it reflected their needs and risks, and their views were central to the care they received. Nationally recognised clinical tools were used to assess people’s risks and the support they needed, including those relating to malnutrition, skin integrity and frailty. This information was used to guide staff on how to support people well, in line with good practice. People and relatives were happy with the care and support provided. One person told us, “They seem to take care of everyone and make sure they are happy.”

People received appropriate support with nutrition and hydration. Where people had specific dietary needs identified following a Speech and Language Therapy (SALT) assessment, appropriate food and drinks were provided. People were happy with the meals and drinks provided at the service and we noted drinks and snacks were available to people when they wanted them.

Leaders and staff worked well together and with other services to ensure people received the support they needed. People’s health and wellbeing were monitored, and their care documentation was updated regarding any changes, to ensure the care staff provided continued to reflect people’s needs and risks. Referrals to community agencies were made when people needed additional support to meet their needs and ongoing communication took place with any professionals involved in people’s care. The service had a good relationship with their local GP and weekly meetings took place, where any health concerns could be discussed. Staff told us internal communication was effective. One staff member commented, “Communication during handovers (between shifts) is good. They tell us anything we need to know, and we pass on any issues. There’s a diary in place too which helps.”

Leaders and staff supported people to live healthier lives and improve their wellbeing. People’s healthcare needs were assessed, monitored and reviewed regularly, using recognised clinical tools, such as the Malnutrition Universal Screening Tool (MUST). Their care documentation was updated to reflect any changes, and these were communicated to staff. When people needed additional support to improve or maintain their health, community professionals such as GPs, community nurses and speech and language therapists were contacted. A person told us, “If you need a doctor, they are straight on it.”

People’s care documentation included detailed information about their healthcare needs, medical history and medicines, to guide staff on how to support them to maintain or improve their health. Staff received training in areas such as first aid, dysphagia (difficulty swallowing) and diabetes, to help them identify health concerns and support people to manage their health needs.

Staff routinely monitored people to ensure any concerns were identified and appropriate action was taken to meet their needs and improve their quality of life. Nationally recognised tools were used to monitor risks to people’s health and wellbeing, such as skin integrity and malnutrition, and people’s care documentation was updated to reflect any changes. If people became unwell or their condition deteriorated, staff escalated their concerns to senior staff or management.

GP reviews took place weekly, allowing any health concerns to be identified and any necessary treatment or investigations to be arranged. Referrals were made to community professionals when people needed additional support and updates about changes in people’s needs or risks were shared with any professionals involved in their care. A staff member told us, “We know people well and monitor them and chat with them. We can tell when something is wrong.” One community professional told us staff raised concerns, sought appropriate healthcare professional advice and advocated for their residents well.

Records showed people’s consent was sought and recorded when they came to live at the service. People’s care documentation included information about their ability to consent to their care. When people were unable to express their views, capacity assessments were completed and best interest decisions were made in consultation with their relatives or representatives, in line with the Mental Capacity Act (MCA). This helped to ensure any decisions made were in their best interests. Information about people’s ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decisions was included in people’s care documentation and was easily accessible in the event of an emergency.

We observed staff routinely asking people for their consent before supporting them, for example when administering their medicines or helping them to move around the service. People told us staff sought their consent before supporting them and their wishes and decisions were respected.