Bramwell

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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff told us, and records supported, that people’s needs were assessed and documented comprehensively. Before people were admitted into the home thorough assessments were completed which included their individual preferences as well as their support needs.

Staff said, “Every person is different. We gather as much information as possible about the resident and past history, religion, culture and beliefs and use the information to tailor the care plan suitable for the individual.” A person told us, “They’ve asked me about what I want. They’ve asked me about whether I’m religious.”

We saw that people’s needs were regularly reviewed to ensure people continued to have their needs met.

The service 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 registered manager had appointed champions whose role was to ensure care was delivered in line with best practice. For example, there was an oral health champion, skin integrity champion and a dementia champion. Throughout the home there were noticeboards with lots of current good practice information and legislation. For example, for supporting people with dementia there was reference to the Tom Kittwood model of person-centred dementia care.

People were supported with their hydration and nutritional needs. A person told us, “I am a bit underweight, so they give me thick soup which is delicious.” A family member told us, “Drinks always in the dining lounge area; jugs of juice, cups of tea, and family are invited to have some, people are encouraged to drink.”

We saw plenty of choice of fluids throughout the home and we observed mealtime where staff gently encouraged people to eat and drink and respected their choices.

The service 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 said, “We have clear handovers, good teamwork and ensure information is shared so residents receive consistent care while maintaining dignity and respect.”

A health care professional who worked with the service told us that communication was good and described a positive joint working experience.

The service 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. The registered manager told us, and records showed, the service worked in partnership with a range of healthcare professionals, including occupational therapists (OT), dementia outreach team (DOT), and general practitioners (GP), with weekly ward rounds with both the GP and OT. They stated, “new admissions will automatically go on the rounds to get assessed for equipment or any change of medicines.”

Staff were trained to support people with specific health needs including diabetes, dysphagia, epilepsy and oral health.

Family members told us how they were kept informed by the service about various healthcare and hospital appointments that staff supported people to attend. For example, a family member told, “[Named loved one] has got dementia and gets infections which make them get delirium, when episodes start they contact us and say they are doing a water test and they get a GP, they are on it.”

We saw evidence of daily meetings where specific concerns around people’s health and wellbeing were discussed including any appointments or changes in care, to ensure consistency.

Staff 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.

All staff we received feedback from were able to clearly describe how they monitored people to ensure their wellbeing and safety; because staff knew people well, they were proactive in identifying any change in people’s needs or presentation.

A family member said, “What impresses me is their attention to detail and they know when something is off…they are on top of it, they act quickly and ring me quickly, it is a very responsive service.”

A healthcare professional that worked with the service said, “Urgent responses and reactive care are escalated to the practice…often with a care home consultation questionnaire being completed by staff to provide the duty GP a more thorough triage of the resident concerned.” Thus, demonstrating the staff’s competency in managing people’s care.

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

Staff said, “I always offer the choice of asking residents what they would like to eat or drink and respect their preferences wherever possible. I will give support to make their own decisions. I don't assume they lack capacity just because of age, dementia, or disability.” We observed staff asking people for consent, offering choice and respecting people’s decisions.

A person told us, ““Everyone checks that I am ok before doing anything for me. When in the shower, they let me wash what I want to. I thought it would be awkward but it’s not.” Another said, “They never do anything without asking me.”