Brooklands Nursing Home

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 requires improvement. At this assessment the rating has changed to 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 before admission, including their physical, mental health, social and communication needs. Families, carers and relevant professionals were involved where appropriate. Prospective people and their relatives were encouraged to visit the home to help decide if it was suitable.

People and relatives shared information about what was important to them, such as routines, preferences and life histories, which helped staff provide personalised care. Staff told us they had sufficient time to read care plans and demonstrated a good understanding of people's needs, preferences and individual circumstances. One member of staff said, “I am given opportunities to read residents’ care plans and risk assessments. This helps me understand people’s individual needs, risks, preferences and the appropriate support they require.”

Where appropriate, people’s relatives had access to an electronic app which enabled them to view care plans, daily notes and updates about what people had been doing. Feedback about this mostly positive. One relative told us, “The app we have is great, we can see what is going on with [relative] all day, and they put everything on it, but the communication is very good anyway.”

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.

The provider used recognised clinical assessment tools to monitor people's needs and identify risks. For example, people at risk of malnutrition had a Malnutrition Universal Screening Tool (MUST) assessment in place, which was reviewed regularly to monitor changes in risk and ensure appropriate action could be taken where needed.

People told us they had enough to eat and drink to meet their nutritional needs, and feedback about meals was positive. One relative told us, “The food is very good, and [relative] enjoys it.” Another relative said, “They look after [relative] so well and make sure [relative] eats and is encouraged with the food [relative] likes.” We observed a mealtime at the service. People were encouraged to make choices about their meals and drinks, and staff sat with people during the meal, engaging them in conversation and providing encouragement where required.

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. Care records demonstrated the service worked appropriately with a range of external healthcare professionals to support people's health and wellbeing. People's relatives described how the service kept them informed about changes in their loved one's health and wellbeing. One relative told us, “I am always updated on [relatives] wellbeing and anything that goes on. We get a call if anything is wrong. When they were changing [relatives] medication, we got a call.”

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.

People had access to a range of medical and therapy professionals, including a GP, speech and language therapists, and podiatrists. The service made referrals to appropriate health services when people’s needs changed. One professional told us, “Staff contact me appropriately, and referrals are made in good time, reflecting a strong understanding of when external professional input is required.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

We saw that whilst some clinical needs were monitored, for example weights and skin integrity, we were not assured that the provider consistently monitored outcomes effectively. This was due to gaps in documentation and care plans not always being updated to reflect changes in clinical advice. As a result, monitoring was not always completed in line with the interventions recorded in people's care plans.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Staff had received training in the Mental Capacity Act (MCA) and demonstrated a good understanding of its principles. However, records did not always fully evidence decision-specific capacity assessments. Mental capacity assessments had been completed; however, some contained incomplete information, including blank sections intended to capture the person's wishes, feelings and preferences. In some cases, records lacked sufficient detail about the support provided to help the person make the decision and the views of family members or others involved in the decision-making process. This limited assurance that MCA processes had been fully considered and documented in line with best practice.