Archived: Bright Brains Global Limited

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• 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.This is the first assessment for this newly registered service. This key question has been rated inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to people’s consent not being sought in line with the Mental Capacity Act 2005. People did not have appropriate access to health care professionals in relation to their health needs.

This service scored 29 (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 wellbeing was not always considered when reviews of care were undertaken by the provider. One relative who was the person’s advocate told us they were not always involved in the review of their loved one’s care. A person’s transition plan to moving to another service was poorly managed. The service had not involved the family in the person’s proposed move to one of their supported living services to ensure it met their needs. Whilst we saw other reviews of care had taken place by the provider/registered manager there was very little detail on how people had been involved.

For people that were receiving home care, there were no assessments undertaken before the package of care was taken on. The care plans lacked any reviews of the people’s changing needs.

People did not always receive support that was in line with good practice standards to ensure compassionate and therapeutic care and support. The leaders told us they had not sought input from professionals to support the guidance in all people’s ‘Positive Behaviour Support Plans’ [PBSP] for people (a document created to help understand behaviour and support behaviour change in adults who have learning disabilities). Where people were at risk of malnutrition, the provider was not always completing a Malnutrition Universal Screening Tool (MUST). This left people at significant risk of harm. The provider and staff were also not aware of the statutory guidance around RSRCRS, so they were not assured they were providing best practice care and support to people with a learning disability and autistic people.

The provider did not work well across teams and services to support people. We found the provider and staff were not always providing the professionals with accurate feedback on people’s care, particularly around incidents of distressed behaviours. When staff were completed night checks relating to people’s care, these forms were being completed retrospectively (in the morning) as staff that were required to be awake at night were sleeping. This meant staff coming on duty would not have the most accurate information on how the person was through the night.

Whilst there was some information around people accessing specialised health support for a specific heath issue, there was also a lack of information in people’s care plans on how they were supported with their other health care including how they accessed the dentist, optician and GP. Records were chaotic and difficult to navigate to review this information. Two people’s medicine reviews were only planned after we required care documents and there was no record in their care plans on when this was last undertaken. The GP had recommended 1 person’s diet needed to be monitored as their cholesterol was high. However, we noted from the person’s (who lacked capacity) daily support records the person was still eating high fat foods regularly. This placed the person at risk of health concerns.

Other people were referred to the health specialists such as neurologist or occupational therapy. Their support records suggested staff were following the guidance provided by the specialist.

People’s health and wellbeing were not always being reviewed relating to people’s quality of life. The provider told us all people were allocated a key worker. A key worker is a member of staff who makes sure all staff involved in person’s support are working together, and that the care plan is being followed and is working well for the person. They ensure that any assessments, care and treatments are explained clearly to the person and their support is consulted with them. The provider told us the keyworkers would have a meeting each month with the person they were supporting. However, when we asked for evidence of these meetings, they were not being undertaken monthly. The meetings recorded that health care was being reviewed but there was no evidence how people were being involved. In addition, staff we spoke to that were people’s key workers, lacked knowledge on people’s background histories. This meant these meetings would not be as effective as they could be.

Leaders and staff did not act in accordance with the requirements of the Mental Capacity Act (MCA) 2005 and associated code of practice, or their own MCA policy. Where people lacked capacity to make complex decisions, the provider had not undertaken decision specific capacity assessments. For example, we were told all people lacked capacity to make complex decisions. We noted that 1 person had locks on their kitchen cupboards. Staff told us this was to stop the person consuming large quantities of sugar and salt. There was no decision specific capacity assessment in relation to this or evidence of any discussions around what other least restrictive measures had been considered. The same also related to another person that had a camera in their room which staff told us was to monitor if the person had a seizure.