New Bradley Hall

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

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to moving into the home. One relative told us, “We chose this home as we knew it was good. We were involved in the assessment, and we provided lots of information about [person] needs and preferences.” The registered manager told us preadmission assessments were completed face to face to establish if the home could meet the person’s individual needs in all areas of their care requirements. Assessments considered peoples protected characteristics, as identified in the Equality Act 2010. This included people's needs in relation to their gender, age, culture, religion, ethnicity and disability.

The registered manager told us people received a gift and a card when they first moved into the home as a welcome gift.

People and relatives confirmed they were involved in the ongoing review of their care. However, there was limited evidence within the records to support the involvement of people or their representatives. This feedback was shared with the management team who advised this would be addressed. We saw this was added to an action plan developed in response to our assessment.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People received care and support which was delivered in line with evidence-based good practice and established standards, ensuring staff actions were guided by current research, and sector-specific guidelines. Staff were given opportunities to access a Dementia bus which was booked on an annual basis. This bus enabled staff to access a mobile immersive training simulator that lets people with healthy brains experience the physical and mental challenges of living with dementia. It uses specialised tools like distorted glasses, loud headphones, and spiky shoe inserts to recreate sensory overload and confusion. The registered manager also told us training has also been booked with the Alzheimer’s society focusing on supporting people when they become distressed.

The provider had previously commissioned for a dementia consultant to visit the ground floor home and advise on how the environment could be modified to become more dementia friendly. In response to the recommendation’s changes were made to signage, and the colour of handrails and toilet seats.

The home was currently applying to renew their Gold Standards Framework (GSF) award which they had achieved previously. The award is beneficial for care homes because it helps staff provide proactive, person-centred care, particularly for people with frailty, dementia, long-term conditions, or those approaching the end of life. It is designed to improve quality of care, communication, and advance care planning.

This evidenced the provider’s commitment to continuous improvement and the delivery of care in line with nationally recognised standards.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People and relatives confirmed they had access to healthcare professionals when they needed them. One person said, “If I need a doctor I get put on the list for a visit, they come to the home every week I think.”Another person said, “I have my routine check-ups as and when needed, staff sort all that out.”

We saw the advance nurse practitioner was a regular visitor and a source of advice and direction for the staff in relation to people’s healthcare needs. Advice was shared with the wider team in handovers, and team meetings in addition to updates recorded in peoples care records.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The management team had regular weekly meetings with key staff to maintain oversight of people’s health and wellbeing. These meetings covered a variety of areas including nutrition and hydration concerns, and skin integrity, and management issues. Senior staff escalated all relevant concerns to healthcare professionals for necessary action.

Most people were happy with the food provided. One person told us, “I like to have a healthy diet, staff always give me fresh fruit with my breakfast, the food is very good here.” A relative said, “[Person] is very fussy with food. Staff always accommodate this and [person] can have food what they like, nothing is too much trouble.”

The kitchen staff were aware of people’s dietary needs and meal preferences. Kitchen staff told us they were kept updated about any changes and about new admissions. We observed people who required a modified diet had their food presented respectfully. We observed efforts were made to ensure the mealtime experience was a positive one for people, menus were available for people to refer to, and music was played in the background. We observed individuals requiring support with meals were assisted in a dignified and respectful manner.

Although the provider routinely monitored people’s care to continuously improve it records did not always reflect this.

The provider used clinical tools for monitoring people’s health and well-being which were incorporated within peoples care plan and risk assessments. For example, staff used a Malnutrition Universal Screening Tool (MUST) tool to monitor people at risk of malnutrition, and various monitoring tools such as fluids charts, bowel, and skin repositioning charts. However, we found in some instances the monitoring charts were not always effectively evaluated to ensure outcomes met people needs. For example, some fluid charts we reviewed showed people had not reached their daily target, some repositioning charts showed people had not always been repositioned in accordance with the frequency on their care plan. We did not find evidence that people had experienced avoidable harm. However, gaps in evaluating fluid and repositioning records meant staff and management could not always demonstrate that risks were reviewed and escalated consistently.

We raised these issues with the management team who were receptive to this feedback and took immediate action to address this. We saw a new care plan audit was currently being trailed which included a review of a person’s monitoring tools.

Although people were told about their rights around consent and this was respect, some records did not support discussions held.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA).

Although people and relatives told us their consent had been obtained when restrictive equipment was installed for people’s safety, the records to support this was not always in place. For example, some people used sensor equipment in their bedrooms for their safety, however a mental capacity assessment or best interest decision was not always recorded to support how consent had been obtained. We raised these issues with the management team who were receptive to this feedback and took immediate action to address this. A full audit was undertaken of all restrictive practices in the home and an action plan developed to consult people, and their representatives and implement the required records for those people who did not have these in place.

People told us staff gained their consent before providing support. One person said, “The staff always ask if it’s okay first before they provide any care to me.” A relative told us, “[Person] cannot make decisions, and I have the authority to help with this. I have provided the paperwork for this, and I am involved in making decisions for them.”