Brantwood Hall Care 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 inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

This service scored 29 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

There had been no new admissions at the service since the last assessment due to a Local Authority commissioning restriction. However, gaps and inaccuracies in people’s records meant they were not always reflective of people’s current needs, indicating an ineffective assessment process. People’s wellbeing was not always considered, and some people’s communication needs were not met.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

Shortfalls in relation to quality of care meant care was not being delivered in line with national best practice guidelines, including supporting people living with dementia. There was a lack of dementia friendly resources and activities were not provided in line with people’s needs. Some staff had not completed dementia training and therefore were unable to offer an evidence-based approach to dementia care. One relative told us, “I think the carers are lacking in dementia training. They don’t have enough staff, or enough staff with skills with dealing with people with dementia.”

The mealtime experience did not meet the needs of all people, for example, 1 person told staff they did not like the meal they had been given, yet no alternative was provided and some people waited over 40 minutes for their meal.

The provider did not work well across teams and services to support people.

People had access to health professionals. However, shortfalls in relation to records meant we could not be assured they were detailed and accurate to support effective monitoring and safe care, in line with professional advice. In addition, 1 person had been for a hearing test and required hearing aids. The person did not have them and told us this was because staff had not renewed them.

Staff were ineffectively deployed and did not work well together as a team. This meant people did not always have their needs met.

The provider did not support people to manage their health and wellbeing, so people could not maximise their independence, choice and control. Staff did not support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were not encouraged or supported to remain physically active or access the local community. There was a lack of meaningful activity for people, particularly those who were in their bedrooms or cared for in bed. Some people were socially isolated and received limited support to enhance their wellbeing.

People’s independence was not consistently supported. For example, 2 people were not given access to walking frames when they were in communal areas, which they needed to mobilise. People did not always have choice and control over their care and wellbeing. For example, 1 person enjoyed football, however staff told us the person couldn’t sit in the area where this was on TV as staff needed to supervise them.

Lack of effective oversight of the service meant the provider had not ensured people were supported to maintain their health or wellbeing, placing them at risk of deterioration and poor outcomes.

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

Ineffective oversight processes meant people’s needs, wishes and wellbeing were not being monitored or reviewed to support improvements in their quality of life and achieve positive outcomes. For example, concerns were raised during the last assessment in relation to 1 person who was neglected, isolated and not meaningfully engaged. However, during this assessment the situation for the person remained the same. One professional told us, “I feel so sorry for [person]. I've known them 7 years. [Person] is tortured. They used to be able to go to a quiet lounge. Now when I come, they are always in their room. Their mobility has deteriorated. Care is not being maintained or personalised for people with complex mental health needs.”

Lack of details and inaccuracies in records meant staff lacked guidance to support people safely, meet their needs and achieve positive outcomes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

People’s views and wishes were not evidenced in care records. There was no evidence of them being involved in reviews. People were not always given a choice, for example, in relation to where they spent their time. A lack of choice meant we could not be assured people consistently consented to their situation or the care being delivered.

Mental capacity assessments were in place and records reflected people’s decision-making abilities. Where people lacked capacity, best interest processes had been followed. Applications for Deprivation of Liberty Safeguards (DoLS) had been made. However, the provider did not maintain effective oversight of people’s DoLS in relation to submitting the required notifications to CQC.