Brainkind Neurological Centre York

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• 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

This means we looked for evidence that the service met people’s needs. This is the first assessment of this service. This key question has been rated Good. This meant people’s needs were met through good organisation and delivery.

Staff worked well together and in collaboration with people, carers, and external partners. The service used the neuropsychiatry plus model together with the neurobehavioral model which was appropriate for the patient group. Staff provided person-centred care and completed robust care plans and assessments with people. They listened to people and made changes following feedback. Staff considered people’s individual needs and protected characteristics to ensure there were no barriers to access and that people received equity in experience and outcomes. The service took concerns and complaints seriously and responded appropriately.

We have not awarded this service a score for Responsive.

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

People told us that they were encouraged to be involved in their care and treatment plan and knew who they could approach to request information from if needed. Staff completed various nationally recognised tools and assessments when developing treatment plans.

People’s needs were understood, and people were able to engage fully in their treatment plans. They said staff were respectful and knew about their individual needs.

We observed staff engaging with people in a person-centred way, adjusting their approach according to their needs.

Care plans were person-centred, and people were involved in their development and reviews. Clinical staff received ‘my plan’ training as part of their induction to ensure they understood and were competent in the care planning process. Care plans had a ‘my plan’ narrative which contained actions and checklists to help promote individualised care.

Managers completed monthly personalisation audits on a sample of records to ensure care plans were individualised. Psychology staff completed neuropsychological assessments and one to one assessment to ensure therapeutic needs were met.

All staff we spoke with were passionate and committed to delivering good care. Staff provided one-to-ones and built good therapeutic relationships.

Managers had regular engagement with stakeholders and funders, inviting them to regular meetings and care programme approach meetings.

Care records demonstrated that people were actively involved throughout their care journey. We saw people and carers were routinely involved in their care plans and multi-disciplinary meetings. Patient voice was well documented in their own words and records documented when people did not wish to be involved.

Staff completed risk assessments for each person on admission and reviewed this regularly, including after any incident.

People knew how to request information regarding their care and treatment. Staff made sure people could access information on treatment, local services, their rights and how to complain. Wards had notice boards in patient areas with a variety of information to support this. However, on Brook ward, there was no information on display about how to contact the independent mental capacity advocate (IMCA), or the independent mental health advocate (IMHA). On Tarn and Foss wards, information about the IMCA was also not on display. Additionally, there were no easy read versions of complaints policies available for people to access. Nevertheless, people we spoke with were aware of their right to complain and people were given a welcome pack on admission that contained this information.

The provider had recently introduced a communications system with assistive technology. This included monitors with touch screens in people’s bedrooms to aid two- way communication, orientation and familiarisation.

All carers we spoke with described excellent communication from staff. They told us they frequently provided updates and kept them informed in changes in their loved one’s condition.

The provider had a data protection officer to ensure compliance with GDPR (General Data Protection Regulation). All staff completed GDPR training to ensure they stored and shared information appropriately.

People told us that they were encouraged to be involved in the development of their care and treatment and felt involved in their care. They felt listened to when they voiced their preferences or asked questions about their treatment or medication. People were able to attend monthly support meetings and had access to independent advocacy.

Carers, friends and families attended ward rounds and multidisciplinary team meetings where appropriate. Senior staff nurses made weekly calls to carers and there was evidence of ongoing carer involvement within care records.

Staff understood the policy on complaints and knew how to handle them. People could raise concerns with any of the team, and they would try to resolve them as quickly as possible. Some people fed back that they did not know how to make a complaint. However, information was readily available on how to raise a concern or make a complaint. Staff were visible and available for people to speak to as and when needed. Staff were observed engaging with people.

Managers investigated complaints, categorising these based on severity or impact. There had been 14 complaints in the previous 12 months with no particular themes or trends identified. The provider also kept a log of informal complaints raised by families and people, with a total of 23 during the last 12 months.

We reviewed 4 complaints and saw these were investigated in a timely manner. Managers made efforts to ensure that any issues were resolved, and that people and carers were given feedback. Managers shared feedback from complaints with staff and learning was used to improve the service.

IMHAs and IMCAs supported people in giving feedback to the service where they requested this. Care records specified whether people had advocates in place.

Managers circulated patient feedback forms quarterly which they reviewed during clinical governance meetings.

The service accepted referrals from across the UK and admitted people in line with specific criteria. Managers held weekly referrals meetings which meant they could identify any additional information needed and plan which member of the multidisciplinary team would visit the person to assess their needs and suitability for the service. There were no waiting lists for admission. All admissions were planned and managers provided staff with admissions information prior to people’s arrival.

People had access to a range of professionals including a dietician, psychologist, speech and language therapist, and an occupational therapist. Staff worked as part of a multidisciplinary team model where all professionals worked collaboratively to deliver holistic rehabilitative care.

The provider ensured people had appropriate support and access to services upon discharge. This included ensuring section 117 aftercare arrangements were in place. They involved community teams in the care progress and ward round meetings in preparation for discharge.

People’s human rights were protected; they were supported by staff who promoted equality and helped them overcome barriers to care.

We did not identify any barriers to care, support and treatment. The service complied with legal equality and human rights requirements, including avoiding discrimination. They had regard to the needs of people with different protected characteristics and made reasonable adjustments to support equity in experience and outcomes.

Staff supported people with specific religious and cultural needs. The service provided a variety of food to meet the dietary and cultural needs of individuals. Staff made sure people could access information on treatment, local services, their rights and how to complain. People were asked if they had any unmet spiritual or cultural needs, and this was documented in care plans. Interpreters were used to support people with language barriers.

Staff reviewed and discussed feedback, complaints and compliments in governance meetings. People’s feedback was collated and reviewed regularly, including any improvements made to service provision when required.

Staff held regular care programme approach meetings involving family members and their wider network. Discharge planning started soon after admission, in line with best practice. The multidisciplinary team considered a range of possible outcomes for each person based on their individual needs.

Staff told us discharge planning could be complex, depending on the available support in the person’s local area and the funding needed to finalise the package of care. Nevertheless, there were clear processes in place to ensure all relevant individuals were involved in planning and preparing people for discharge. This included social care, community teams, housing, and family members.

Care records showed that care and treatment focused on rehabilitation and planning for the future. Care plans referred to therapeutic practice, goal setting and focused on independence. People were involved in discharge planning meetings, and a detailed plan was developed with people and carers. This ensured people’s choices and preferences were always accounted for within discharge plans.