Bradbury Gardens

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 75 (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 health, care, wellbeing and communication needs were thoroughly assessed and reviewed to achieve positive outcomes. Staff worked closely with people, relatives and professionals to understand individual needs and aspirations. Comprehensive assessments informed personalised support, with people at the centre of decision-making.

People’s assessments included details of their communication needs. People’s care plans also detailed when changes in people’s physical presentation, or emotional state, may indicate a deterioration in their health or wellbeing.

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-

People received support from staff who had the skills, knowledge and training to meet their needs safely and effectively. People and relatives told us staff knew how to support them and provided consistent care. One relative said, “[Staff] are on the same page regarding the care and support provided. I could not ask for more”.

The service used recognised communication and behavioural support approaches to improve people’s outcomes. Staff described the use of Positive Behaviour Support (PBS) training and personalised communication methods, including communication and AAC technology. People had access to specialist professionals including nurses, physiotherapists, epilepsy specialists, GPs etc. Staff responded promptly and appropriately to changes in people’s wellbeing and communicated effectively with healthcare professionals 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.

The provider worked with staff, teams and partner organisations to coordinate people’s care and support. Staff communicated effectively with one another, relatives and external professionals to help ensure continuity of care. Multidisciplinary meetings were held regularly to review progress and plan support, involving people and those important to them wherever possible. These multidisciplinary teams were based around people, and a range of communication channels were set up for each person so information sharing was timely and effective. A service manager told us, “We all work as a team to provide high quality of care, such as medical health, personal care, therapies etc. National Star do amazing things around therapies; each individual is assessed [for equipment]. It helps them to maintain their physical health. We work in partnership with physiotherapists and occupational therapists.”

Relatives described positive working relationships with staff and managers and told us people benefited from coordinated support from a range of professionals. Staff actively advocated for people and worked with relevant organisations to achieve positive outcomes. A relative told us, “I am over the moon with the care and support my loved one receives. The change in their behaviour has been massive, they are so much calmer than in the past”. Another relative said, “I know my loved one is happy and safe. The staff are well trained and know how best to support my loved one”.

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 were encouraged and supported to make decisions about their own care needs by staff who understood their requirements and preferences. People were supported to make healthy lifestyle choices and take part in activities that promoted physical and emotional wellbeing. The service provided opportunities for exercise, recreation, learning and community participation, including sports activities, outdoor pursuits and educational experiences. A staff member told us, “They’ve all got timetables and they all do different things, [people are supported to be] very active. [Some people do] work experience in the National Star shop, [some work in a local garden centre], [some people do] swimming, gym etc. They all do very different things.”

The provider’s staff regularly monitored people’s health and supported people to access primary healthcare support, as well as specialist hospital support when needed. Staff knew people well and were able to identify and changes in their presentation, emotional state or distress, which may show a deterioration in their health or wellbeing.

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.

People told us they experienced positive outcomes from the service. There were effective approaches to monitoring people’s care and treatment and their individual outcomes. Staff engaged with people to ensure their life ahead was a life they chose. Staff discussed with people to find out their short, mid, and long-term life choices, goals, and ambitions. This enabled outcomes to be planned by each person and care plans created to support those outcomes to be achieved.

There was a robust approach to monitoring the effectiveness of people’s care, treatment and support, and action was taken to continuously improve it. Clinical monitoring tools were used to monitor people’s health and identify any deviations from their baseline health at the earliest possible opportunity. We heard how one person’s health needs had been successfully monitored and managed by effective partnership working and clear communication. As a result, the person had seen clear improvements to their health in the last 2 years and now had significantly more control over how their health was managed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff completed training and followed an up-to-date policy relating to capacity and consent. They supported people to exercise their rights and encouraged people to make decisions about aspects of their daily care routines. Staff told us they always obtained consent from the person before supporting them with personal care tasks.

People’s care plans contained assessments of people’s individual capacity to consent to specific decisions about their care. Where people were unable to meaningfully consent, appropriate best interest decisions were made and recorded in their care plans.

We observed in practice that staff recognised the importance of seeking consent before providing care and demonstrated a person-centred approach. Staff adapted their communication methods to help people express their wishes and preferences in a way that was meaningful to them. Observations showed staff taking time to listen, explain options and support people to participate in discussions about their care.