The Brambles Apartments

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.

This is the first assessment for this service. This key question has been rated Good.

This meant people’s needs were met through good organisation and delivery.
 

This service scored 79 (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 was exceptional at making sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.
Care needs were anticipated as staff had a deep understanding of the person’s communication style, interests, culture, and preferences. Each person had a PERMA plan which outlined what, their wishes, values and personal goals were, and how staff would support them in achieving these. For example, we saw evidence of peoples interests and what they wanted to achieve expressed in their apartments and through their assessments and care records, with each being unique and reflective of the person.
Relatives consistently told us their family members received highly personalised care. They described staff as knowing people extremely well and taking time to understand what mattered to them as individuals. Relatives said staff actively involved them in decisions, welcomed their input, and encouraged them to remain closely involved in people’s care. A relative told us, “Managers are very good, they will send regular pictures and messages, it helps us still to be involved and know what [person] is doing, they give their heart and soul and genuinely care about people it’s like having another family.” Another relative told us, “We are involved with [person’s] care plan, our wishes are considered.”
We observed care being delivered in line with people’s care plans and personal preferences throughout the assessment. Staff routinely offered people meaningful choices and respected their decisions, adapting their support in a way that promoted dignity and autonomy. Interactions between staff and people were warm, respectful, and unrushed and reflected strong, trusting relationships. People were relaxed, comfortable, and confident with staff. We saw staff using a calm, caring approach, engaging people in conversation, and responding sensitively to non verbal cues.
Relatives told us they were welcome to visit at any time, and staff were welcoming and friendly and they were welcome to attend any events or celebrations that were arranged by the provider. A relative told us, “Staff send updates and photos at least once a week or more, if they take [person] out, we get photos so far I have been sent over 600 photos since [person] has been here, it makes us feel involved.”
 

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People could access the care and support they required. This included seeing their doctor, dentist or optician. Relatives told us they were confident in the staff to summon additional medical support if needed. One relative told us, “When [person] was at home, [they] wouldn't go to the dentist or optician, so this is a big change.”

A health professional told us, “The service wants to do joint working” and includes others in meetings or reviews.
The registered manager told us how they would arrange multi-disciplinary team (MDT) meetings with partners to discuss changes in people’s needs and consider least restrictive options and agree best interest decisions which would be documented and confirmed by the funding commissioners.
People’s care records, alongside feedback from external professionals, demonstrated strong collaborative working. This meant people received care that was safe and responsive, maximising people’s health and well-being, quality of life and independence.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
The provider was aware of their responsibilities in relation to The Accessible Information Standard, (a legal requirement for social care providers to ensure information and communication are provided in ways that meet people’s needs and can be understood) was being met.
Information about how a person communicated was detailed in people’s care plans and risk assessments. People’s communication needs were met, and information was tailored to people’s individual needs.
We observed staff using picture cards with people who could not verbally communicate, staff also told us that for some people they would use Makaton signs to communicate with them.

The service also made referrals to the speech and language therapist when needed.
 

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 and told them what had changed as a result.
Effective systems were in place to enable people, relatives and professionals to share feedback and raise any concerns.
People were involved in regular meetings and discussions about their support and what they wanted to do, and we observed people involved in the handover meeting to give their own handover feedback to night staff and they were encouraged and supported to do this.
The registered manager met regularly with people living at The Bramble Apartments to see how they were progressing or if some things needed to change. For one person this was further developed with the service creating a “worry” box for the person to make notes about what they were worried about and put it in the box for staff to review as the person found it easier to write things down rather than verbalising some things. For example, concerns raised through the worry box highlighted that the person wanted more time with specific staff members. This enabled management to review staffing allocations and discuss these preferences with them, helping them feel listened to and involved in decisions about their support. In other instances, staff have used information from the worry box to reassure the person regarding concerns about activities and personal possessions, reducing uncertainty and supporting them to become settled and re- engaged more quickly following periods of distress. Overall, the worry box has increased the person’s opportunities to communicate their worries in a meaningful way, improved staff understanding of the triggers behind when people become distressed and enabled earlier intervention and personalised support to meet their emotional needs.
Complaints were dealt with promptly and relatives confirmed that they had been involved in surveys and although no group family meetings were held, regular communication and updates were provided and relatives said they were in regular communication with the registered manager. Relatives said if they had any concerns, they would happily raise them with the registered manager and knew they would be listened to.

The provider made sure that people could access the care, support and treatment they needed when they needed it.
Relatives told us their family members received care and support, which was accessible, timely, and considered their individual needs. Staff were aware of any reasonable adjustments people needed to engage fully into life at the service and to access community activities. Staff recognised the importance of people not facing barriers to access health and social care services and professionals provided positive feedback about how well staff worked with them.

Outside space was accessible and included a range of activities that people enjoyed doing, for example there was a trampoline, football net and swings as well as picnic tables and vegetable boxes.
Some people had private gardens due to their needs, as well as being able to access the communal garden spaces.
 

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.
People were supported to get out and about in the local community. Members of staff supported people to engage in a range of different activities of their choosing. A member of staff told us, “[Person] didn't use to go out and now does go out plays football, [person] is happy and interacts well with staff.” A relative told us, “At [person’s] previous place [they] never went out at all and now [person] is out all the time.”
The provider had an equality and diversity policy in place, offering guidance on the importance of treating people equally, underpinned by staff training.
People's care plans were person centred and set out aspects of people's characteristics, beliefs and preferences to ensure people's equality characteristics and needs were respected.
 

People were 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.
People’s end-of-life care wishes were recognised by the management team who acknowledged discussions around this topic could be, at times, difficult. The registered manager told us it needed to be approached sensitively and could take an extended amount of time. For example, for one person who had no family involvement, they took time to sit with the person and explained what it is and then continued to discuss this in weekly meetings including the different elements and this took nine weeks to complete all their preferences. They arranged for the funeral director to visit, costs were discussed and the person was able to pick the coffin they liked. A mental capacity assessment and best interest decision was then made and agreed with their social worker. The person now had an end-of-life certificate, in line with Muslim beliefs.