Brooklands Homecare Ltd - Edenbridge

On this page

• 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

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People’s records did not always contain all relevant information in relation to their individual risks, or up-to-date information about their care needs or the person-centred details that the management and established staff knew about people. There was a risk that newer staff might not know how to meet people’s needs, and in a way that they preferred. People’s daily notes did not always contain the person-centred details of the care staff and people told us staff were providing.

Despite the provider not always operating robust systems to ensure people were at the centre of their care and treatment choices, the care people received was person centred. People and relatives told us staff were kind, respectful and knew them well. A person said, “They are very much on the ball and can read my mind."

The provider had not always understood the diverse health and care needs of people and their local communities, so there was a risk care would not be joined-up, and support continuity.

The provider had not always robustly managed diverse health needs where there was overlap between care provided by the service and support instructions from other services. For example, records containing up-to-date guidance about the management of a person’s skin integrity was not in place and it was not evidenced from daily logs that current guidance was being followed. The management team stated the service did not provide catheter care for a person who was under the district nurse team. Although the district nurse maintained the person’s catheter and changed it, staff were still involved in a level of support on a daily basis around emptying the person’s catheter bag and supporting hydration during calls as well as making sure the area is clean to avoid infection and report concerns. The provider had not adequately assessed or documented guidance for staff in this area to ensure integrated and consistent care.

There were occasions where care provision had not been fulfilled as required. For example, missed visits had occurred, the impact of this on people’s needs had not always been robustly mitigated.

However, the provider made sure people usually received coordinated care that met their assessed needs in most areas. People and relatives told us staff were reliable, arrived at times that suited them and completed all required support. Telephone monitoring showed people felt staff stayed for the full duration and met their needs.

Staff had strong relationships with people and understood their routines well. Many people had the same carers each week, which they told us supported consistency and helped people feel safe. People and relatives valued this continuity. A relative said, “[Staff attending the care calls] really lifts mum and dad and starts the day off beautifully.” Office staff also covered calls when needed to try to maintain service continuity.

The provider supplied information to people in formats that were tailored to their individual needs.

People told us staff explained what they were doing during care tasks and checked understanding before offering support. A person said, “[Staff] mannerisms and the way they explain things, they are very nice people.” Staff adapted communication for people with hearing difficulties or cognitive needs, using visual contact, gestures or speaking more slowly. Staff could explain people’s needs confidently.

People said office staff were approachable, and when they contacted the service with queries, they received helpful and timely responses. Staff used communication books in people’s homes, telephone reviews and instant messaging services updates to share essential information.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care.

The provider made sure people were listened to and involved in their care. People told us staff always asked what they wanted to eat, wear or do during visits. Staff routinely encouraged people to make choices, even when they needed prompting or reassurance. People consistently felt their day‑to‑day wishes were respected. Relatives described staff as “kind”, “patient”, and “wonderful”, saying the service had “made a tremendous difference”.

Feedback from most people and relatives was that they had no complaints about the service. Records demonstrated complaints were investigated, and action taken to resolve them. For example, staff were removed from specific calls when concerns were raised. The service had received compliments from people and relatives which were recorded and shared with staff.

We received mixed feedback from people and relatives about their awareness of formal processes to give feedback. However, all said they had no complaints and survey results showed most people were overall happy with the service provided and felt staff helped keep them safe, enabled them to stay independent and comfortable, and any enquiries were dealt with professionally by the office.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People told us they received care at times that suited them and that staff were flexible when adjustments were required. Office staff reassigned calls promptly if staff were delayed, and people said they were informed when changes occurred.

Assessments were completed face‑to‑face and considered people’s protected characteristics such as cultural and practical needs in relation to any disabilities. The service supported people with limited mobility or sensory needs by adapting communication and providing equipment‑related support such as hoists, standing aids or walking frames.

Where people required input or review from other healthcare professionals or external agencies the service advocated for people to ensure they had fair access to support.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider made sure people had fair and positive experiences. Feedback from people, relatives and professionals was complimentary. People said they felt safe, respected and valued. Staff were described as “gentle”, “like family”, and “very caring”. People experienced good outcomes such as improved mobility, feeling more confident, and reduced stress for relatives through reliable support.

People with communication needs received equitable support, with staff adapting their approach to ensure involvement and dignity.

Although records needed improvement to ensure parity across all people’s care files, there was no evidence that people received different levels of service based on personal characteristics, background or complexity of need. Staff respected people’s human rights and treated people equally. A staff member told us, “Everyone is an individual all deserve to be treated with the respect they deserve."

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Although the provider told us they had processes in place to support people who were progressing towards the end of their lives, the provider needed to improve how it supported people to plan ahead. Although people’s care records contained some information in relation to future plans such as their Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) status; many care plans lacked completed sections on future wishes, advance care planning or preferred outcomes. Several documents noted “no plans at present” without evidence that these conversations had been explored with people or relatives.

The service had received compliments in relation to the end of life care they had provided.