Brooklands Homecare Ltd

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 50 (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’s care and treatment was effective by discussing their health, care, wellbeing and communication needs with them. The branch manager visited people to complete pre-service assessments with them. People and their relatives contributed to discussions. A relative told us, “[Branch manager] came round with someone else and went through everything, they asked all necessary questions.” Pre-service assessments did not assess risks to people but explored people’s preferences and needs; although some detail was lacking people were supported by staff who knew them well and understood their needs, preferences and routines.

The provider did not always plan and deliver people’s care and treatment with them. Reviews of people’s care were not always conducted following changes to their health needs. For example, a person’s communication log listed on 2 occasions they had sustained pressure damage to their skin. A risk assessment such as a Waterlow assessment had not been completed and their information sheet did not highlight they had sores or were at risk of skin integrity breakdown. Staff had appropriately contacted the district nursing team, but a review of their needs had not been conducted by a competent staff member to provide staff information on how to promote healing and avoid deterioration of the sores. The branch manager was unaware of the stage of the sore to allow for thorough documentation and monitoring for additional intervention when needed. Despite the lack of information, staff worked alongside the district nursing team and the sores had healed.

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. Staff knew people very well and we saw multiple instances where they had requested professional intervention in response to peoples changes in health needs. Professionals spoke highly of the service, some comments included, “We communicate with [Brooklands Homecare] frequently. Patients give good feedback about the carers and also I have found that they are very good at following up. We get communication if carers pick up things in patients’ homes, such as, queries and illness. They are very responsive.” And, “I have had many customers who have used Brooklands Homecare. They are certainly an agency that provides consistent, well-managed support and they will always go above and beyond to meet a person’s needs.”

The provider did not always support people to manage their health and wellbeing. People’s health needs were not fully assessed, documented and reviewed which meant staff were not always able to support them to live healthier lives. Managers and staff had not fully assessed the needs of people living with diabetes. We reviewed a person’s information sheet which stated they lived with diabetes. There was no further information given to staff about how they could support them or what signs to watch out for in the event of hypo or hyperglycaemic incidents. Staff were not guided to look out for signs of associated complications, such as, in relation to eye health, foot care, or the increased risk of infections and changes to mood. An information sheet for another person did not include they lived with diabetes; therefore, staff would not know to look out for signs of related ill health. Staff had not received any formal training in respect of supporting people with diabetes.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Despite the lack of care records, staff monitored people well and escalated concerns to improve people’s outcomes. A person lived with emphysema and there were multiple records of staff contacting emergency services when the person struggled to breathe. Frequent additional contact was made with the person’s GP for inhaler and medicine reviews and when staff suspected chest infections. When needed, staff monitored people’s food intake. A staff member told us, “I would always report if a customer was not eating or drinking well or as usual and would also write this in their communication book.We look out for signs of dehydration but make drinks etc available if the customer is not very mobile.”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. People and their relatives told us staff always requested permission before providing support. Comments included, “Yes they do, always.” And, “Yes, they ask [person] everything.” Staff confirmed they requested consent prior to supporting people. The branch manager was unable to provide evidence where people have formally consented to their care and treatment, for photographs to be taken when needed and to share information with other professionals. They showed us where people and/or their representatives had signed a service agreement form. However, the form was regarding service arrangements, not specific consent.