Brainkind Neurological Centre York

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment of this service. This key question has been rated Good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

We saw staff treating people as individuals, with dignity and respect. People said that staff were kind, caring and supportive. Family members and those who knew people well were encouraged to be involved with the care and treatment of their relatives. Staff were visible and available to people, supporting them to maintain their independence, choice and control. Staff provided care and treatment in a way that ensured people’s privacy and dignity. There was a range of appropriate equipment and facilities to support people.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

All rooms had privacy blinds that could be operated by people from within their room. Staff could unlock the privacy blinds to carry out observations at night if needed.

All staff we spoke with were passionate and committed to delivering good care. Staff provided one to ones with people and built good therapeutic relationships. Staff supported people to ensure they were able to communicate their care needs. People said staff were kind and compassionate, but some said they were not always available due to them being busy.

We completed a Short Observational Framework for Inspection (SOFI) as part of the inspection. This is a framework for directly observing and reporting on the quality of care experienced by people who may not be able to describe this themselves. We observed 140 interactions between staff and people. 139 interactions were positive, and 1 interaction was reported as neutral. We observed staff treating people with kindness and compassion. Staff gave reassurance to people when they needed it.

There were many multifunctional spaces on the wards which people could access if they wanted to speak with staff privately.

People said staff were respectful and knew about their individual needs. Staff followed ‘about me’ plans when providing care and were aware of people’s preferences and wishes. People received a range of activities which met their individual needs, dependent on their preferences and abilities.

We observed staff giving reassurance to people when they needed it. Staff were caring and supportive to people. People were asked if they would like to participate in activities and staff respected their wishes if they said no. Staff documented in care records each time a person declined to participate in an activity.

Care plans were person-centred and evidenced that staff supported good communication and individual choice. Where people were unable to communicate their wishes about a particular decision, staff involved family and made decisions in their best interests.

People were generally supported to challenge their care arrangements when they were unhappy, although one person said they did not know how to complain. One person felt they were restricted regarding access to leave.

Visiting times for family and friends were flexible and the service followed a visiting protocol to ensure that all people who wished to visit could do so in an adequate safe place.

There was a range of appropriate equipment to support and maximise people’s independence and outcomes from care and treatment. Information was available on noticeboards informing people of their rights, feedback on care, the complaints process, an activity timetable, meal choices, advocacy and general well-being information.

Care plans demonstrated people were actively involved in decision making and were supported to make their own choices about their care. People were supported to maintain networks that were important to them and had access to family and friends while using the service.

People were involved in all aspects of their care planning. Staff understood people's likes and dislikes.

Staff supported people to ensure they were able to communicate their care needs and helped them develop communication plans. Speech and language therapists helped people whose communication needs required extra attention. Staff referred people requiring communication aids or assistive technology to an external NHS provider who arranged for equipment to support with communication. Staff spoke positively about this but said sometimes people had to wait too long to receive the equipment.

Staff used interpreters and we saw that an interpreter was being used to support a person during our inspection. Managers shared up to date information with staff at the start of each shift to enable them to understand and be responsive to individual needs.

Care records demonstrated that staff were alerted to people's needs and responded promptly and appropriately to these. We saw that the team regularly discussed individual needs and engaged with people and their families in how best to respond.

Managers acknowledged that some staff felt overstretched and very busy on the wards. They said they tried to accommodate the needs of the workforce and made reasonable adjustments in line with legislative requirements.

Managers told us they allocated key worker and named nurse status to staff to ensure equitable workloads.

Managers provided training and gave information to staff to protect their safety. They received breakaway and conflict management training and were provided with peoples’ risk information, for example when escorting them on leave. All staff carried fob alarms.