Bainbridge Court

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 needs were assessed before they moved into the service and regularly reviewed to ensure they were receiving appropriate support. Protected characteristics and diverse needs under the Equality Act formed part of this process. For example, people’s religious needs and preferences were captured.

Assessments focused on people’s strengths and promoted independence. Assessments considered people’s communication needs and how staff could effectively seek their views and preferences. Care plans incorporated associated positive behavior plans to ensure staff had the information to recognise and support people’s emotional state or distress.

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.

Each person had a full and complete initial assessment in place. These were supported with the use of best practice tools and evidenced based practice. For example, the provider supported STOMP (Stopping the Over-Medication of People with Learning Disabilities, Autism or both), an initiative to support the reduction of overuse of psychotropic medication for people with learning disabilities. This ensures that medication is only prescribed for the right reasons, in the right dose, and for the shortest possible time. This practice was supported with the consistent use of positive behavior support to identify the causes of people’s anxieties to support and reduce them.

The service worked well across teams and services to support people. When people received care from a range of different staff, teams or services, it was co-ordinated effectively. One professional said, “Communication was efficient, as the staff team would reach out if they needed assistance or had any inquiries.” One staff member said, “It's well coordinated and everyone is well trained. We have handover in the morning, and we plan the day together. There’s communication. Everyone knows exactly what they need to do.”

Professionals and partners in care said that the management and staff were effective in information sharing and partnership working. Appropriate and timely referrals were made when needed. Information was shared between teams and services to ensure continuity of care, for example when people are referred between services or people required hospital treatment. One professional said, “When an individual transitioned to one of the services provided by Pathways Healthcare, the staff from the previous service participated in the Multidisciplinary Team Meeting (MDT) even after the handover, ensuring they were available to share information and remain involved in the transition process.”

Hospital passports were in place for each person. These were personalised documents that helped people with specific needs, such as those with a learning disability, communicate their health, communication preferences, and personal needs to hospital staff.

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 supported to live healthier lives and had access to healthcare specialists and partners. The provider ensured there were regular monitoring of people’s health. For example, the provider held internal MDT’s (Multi-Disciplinary Team) meetings for individuals at the home. These monitored and reviewed areas such as annual health checks and when the person had accessed clinical services such as the dentist, physiotherapy and the community learning disability nurse. One relative said, “They send somebody when he has hospital appointments. I supported (person) but they sent a carer. They picked me up from home and I thought that was brilliant.”

People were supported to eat healthily. There was a weekly menu in place with options chosen based on people’s choices and favourites. Staff told us that people could eat when they wished but that they often enjoyed meals communally. Some people needed specific support to monitor their dietary needs and staff did this effectively. For example, one person was at risk of overeating and staff monitored this risk well. One relative said, “The diet they provide is full varied and structured. They are managing if he’s had too much.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

Staff monitored and evaluated each person’s outcomes meaningfully, and reviewed their support plan, adapting when necessary. This was achieved through care plan reviews, key worker sessions where outcomes were reviewed and multi-disciplinary meetings with the PBS team. One support worker said, “It’s quite interactive and its very useful to be part of the PBS meetings.” One relative told us, “We have targets now and they are discussed with me. The key worker system is working.”

Professionals spoke positively about the effective approaches to monitor people’s care and treatment and their outcomes. One professional commented about the person they supported, “When the Dietetics referral was finally received, the dietician recommended continuing with the strategies that were already in place. The individual had been experiencing weight loss, and a weight recording system was established for monitoring purposes. Evidence of a gradual weight gain was observed. It was a true joy and privilege to witness and experience the positive outcomes resulting from the delivery of care.”

The provider consistently captured data and information to support the review process. People’s skills were monitored; incidents of distress were reviewed. Support workers were involved in the discussion of people’s progress, and their observations were used to frame people’s support. Training, effective communication and information sharing to and between staff meant they were clear on the standard of care expected from the provider.

At the last inspection, there was an inconsistent approach to Mental Capacity Act and best interest decisions before DoLS were applied for. At this inspection the provider had implemented and embedded the necessary changes to ensure a consistent approach in completing mental capacity assessments and making best interest decisions. Appropriate DoLS (Deprivation of Liberty Safeguards) had been made.

Staff used detailed communication plans as guidance, as well as communication tools, such as PECS, (Picture exchange communication system) so that people’s needs and wishes could be expressed. One worker said, “We offer people choices because we offer person-centred care. Before engaging with personal care or medicines we ask for their consent. They communicate differently and you can tell whether it’s a yes or no (described a facial expression of one person for confirmation).”

Where people did not have the capacity to make certain decisions, appropriate assessments had been carried out, with decisions made in conjunction with those involved in the care, such as family members or health professionals, so that decisions could be made in their best interests. Management and staff adopted least restrictive practices, and clear plans were in place to use positive approaches as much as possible. Where applicable relevant applications had been made. One professional said, “The staff included the family in the decision-making process and would discuss any additional suggestions they might have, explaining why they believed their recommendations would be in the best interest of the individual.”