Bramwell

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People’s care plans clearly evidenced that they were written with people, they contained detailed life histories and preferences.

Staff made sure they got to know people and involved them in choices, as demonstrated in the caring section of this report.

Staff said, “We support residents to be as independent as possible by encouraging them to do tasks they are able to manage themselves, while providing guidance and assistance only when needed.”

Family said, “They are brilliant, they take time with him and have gotten to know us, they are interested in him.”

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff were proactive when people’s health changed, making timely referrals and ensuring professionals had accurate information. A healthcare professional told us urgent concerns, “were escalated to the practice through phone line, often with a care home consultation questionnaire being completed by staff to provide the duty GP a more thorough triage of the resident concerned.”

The service had good links with the local community healthcare services. There was a weekly ward round with the GP, ARRS (Additional Roles Reimbursement scheme) paramedic and Enhanced Health in care homes team for less urgent issues and preventative care.

Families told us they were kept up to date with any changes in their loved one’s health. One told us, “Communication is good, she suffers from UTI’s, they phone and say they are doing the test and they are on antibiotics, they are aware she is prone.”

People were supplied with appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People had communication care plans and staff understood individual communication preferences. Staff told us, “I adapt my communication style to each resident using simple language, visual cues, or gestures as needed and coordinate with care staff and my manager to ensure messages are understood.”

The registered manager told us they matched people with staff members who spoke their first language.

The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

Each unit had its own resident ambassadors, who were people living at the home, with their names and pictures displayed so everyone was aware of who they were and what they do. The role entailed settling new people into the home, reporting feedback on a weekly basis to the management team and assisting with staff recruitment.

The service held regular resident meetings and put actions from feedback up on a “You said, we did” board so everyone could see what has happened as a result of their feedback. We saw evidence of this as at the last meeting people living at the home had requested to have a treadmill, and that arrived on the day of inspection.

The home had a monthly newsletter to keep families informed about what had been happening at the home and any upcoming events.

Families told us how the registered manager acted promptly when they fed back any concerns or suggestions even over what might appear small matters. Family said, “they listened and it happened and [loved one] is happier,” and “any issues they resolve them.”

Staff made sure that people could access the care, support and treatment they needed when they needed it.

The home was purpose built and therefore accessible for all, with accessible outside areas and lifts. With the regular multidisciplinary ward rounds and attentive skilled staff who recognised changes in people’s presentation, people were always supported to access appropriate care and treatment when they needed. This was confirmed by records, people and their families. A family member said to us about this matter, “we have faith in this home.”

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Staff were trained in equality and diversity. The registered manager was innovative and creative in the way they encouraged staff to put themselves in the shoes of the people they supported. For example, getting staff to try and go about their day with dirty glasses.

The champions within the home had the responsibility to ensure people were being supported in a way to achieve positive outcomes.

Families spoke positively about how staff interact with people in a patient and personalised way. A family member told us, “They are very efficient at what they do, constantly tweaking care and are on top of it. It is reassuring for me.”

A healthcare professional said, “Care home staff are good at providing observations to help duty doctor triage and improve patient safety and access to timely appropriate care.”

The service embraced people’s diversity by celebrating a vast array of holidays such as Christmas and Diwali. They also provided food for people’s diverse needs.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

We noted from the records reviewed that people did not have personalised plans in place for the care and treatment they would like at the end of their life. A family member told us, “End of life is not really talked about, there is a DNR in place and [loved one] has refused ongoing medical treatment and the Home respectful of that.”

We saw evidence of lovely compliments received from family members who were very happy with the care their loved ones received in the last days of their lives.