Briar House

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.

This service scored 54 (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 were effective.

People did not always have risk assessments in place to meet their needs, where they were in place, they did not always include enough information.

Care and support plans were in place and had been regularly reviewed, however, we found that changes to care plans recorded on the review had not always been fully incorporated into the care plan. For example, 1 person had a change in the level of the texture-modified diet they received, this had been updated in the review notes, but the care plan still recorded the previous requirement.

Some people’s care plans recorded that they required the use of the full hoist to transfer but did not always include the sling loops they required. This placed people at a risk of equipment being used unsafely.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We viewed daily notes which were task focused and lacked person centred recording. We found they also included some gaps in repositioning records.

The service used clinical tools such as weight logs, food and fluid charts and bowel monitoring. These had been completed as 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. Staff worked collaboratively with health and social care professionals. We found that referrals had been made to different health professionals such as the SALT team, occupational therapists, mental health teams and community district nurses.

We received positive feedback from several healthcare professionals, with 1 telling us, “Staff listen to advice and are good at using their initiative.”

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. We observed that people were offered a range of choices for their meals and that staff supported and encouraged people with their decisions.

We received positive feedback from relatives regarding the activities programme. One relative told us, “[They] always look forward to the activities and socialising.” While another said, “The activities are brilliant and varied. I also see activities happening for bed-bound residents too.”

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. The service used clinical tools such as weight logs, bowel monitoring, food and fluid charts, repositioning records and behavioural monitoring charts. The service did not have clear systems in place to monitor these. We found some inconsistencies with the recording of some records, which had not been identified by the service. Meaning that opportunities to improve care and treatment could have been missed.

Despite this, the service worked well with healthcare professionals in regard to people’s behaviours and physical health needs.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. We found that consent to care and treatment had not always been lawfully obtained in accordance with the Mental Capacity Act 2005.

The service had a consent form in place; however, we found that not all decisions were included on the form and that they had not been regularly reviewed. We also found that where needed corresponding mental capacity assessments had not been completed for the decisions recorded on the consent form.

Mental capacity assessments had been completed for other decisions; these had not been consistently completed and found to be of differing quality.

Where required, people had Deprivation of Liberty Safeguards (Dols) in place or applied for.