Brook House Care Home

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 82 (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 was exceptional at making 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 were central to the care and support they received. People or their family members were part of the process in making decisions to any changes to their care and support in response to their changing needs. A family member told us, “The care plan was updated a year ago and we had regular update meetings.”

Care plans were comprehensive and reflective of a holistic and supportive approach that facilitated the promotion of people’s independence, maintaining of health and enabling them to live a fulfilling life, in line with their wishes and expectations.

Staff demonstrated an excellent understanding, commitment, and enthusiasm for delivering personalised care. This was strengthened by the provider’s robust systems and processes, and by the registered manager’s leadership, oversight, and shared values of a person-centred approach. This approach placed the person at the heart of every decision, action, and interaction. It ensured care was provided in line with people’s preferences, lifestyle choices and autonomy.

Senior members of staff were responsible for reviewing people’s needs monthly, incorporating within the review were all aspects of their care, including wellbeing, preferences and outcomes. In the event a person’s physical or mental health, cognition, mobility or nutrition needs changed, or when external healthcare professionals had made changes, then care plans were updated immediately.

The registered manager advised people, or their family member were encouraged to be involved in care planning and decision-making wherever possible, with formal reviews being held every six months.

Care records were audited by the management team in line with the provider’s governance policy, to ensure documentation was accurate, comprehensive and reflective of a person’s needs.

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

People’s eligibility for funding for their care was identified through the assessment process when undertaken by a local authority. The registered manager provided information and liaised with people or their family members where decisions relating to funding of care were identified, in response to a change in people’s needs or financial circumstance. A family member we spoke with told us as part of the review process, discussions relating to funding had taken place. They told us, “I have discussed the care plan, we also discussed next steps when the funds run out.”

People and their family members spoke affectionately about the service, and the local community. Many of the people or their family members or staff lived locally, which contributed to the sense of community within the service. A person told us, “I used to live across the road.”

People’s care records, alongside feedback from external professionals, demonstrated strong collaborative working. This meant people received care that was safe and responsive, maximising people’s health and well-being, quality of life and independence.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider was aware of their responsibilities in relation to The Accessible Information Standard, (a legal requirement for social care providers to ensure information and communication are provided in ways that meet people’s needs and can be understood) was being met.

People’s communication needs were identified as part of the assessment process, with these needs included within their care plans. For example, the use of hearing aids or glasses to support hearing or sight. Equally, where people’s physical health impacted speech, this was detailed, and guidance provided for staff on how to best communicate, such as short and succinct information and giving people time to respond.

The registered manager informed us they had worked with an external organisation who specialise in sight-loss, which resulted in a person being prescribed yellow tinted glasses to wear to reduce glare and improve contrast by filtering blue light. We noted Alexa devices in some areas of the service, which enabled people through simple voice commands to make requests for things such as music to be played.

Visual prompts were in place throughout the service, including signage for toilet and bathing facilities, garden area, along with notice boards providing information as to activities and the menu for each day. Where people chose to, a picture of themselves was placed on their bedroom door, and in this, with the person’s consent included information about them, such as their preferred name, their hobbies or interests.

Newsletters were produced monthly and were also available on the provider’s website. The newsletters shared information, including photographs of recent activities, updates on menus, highlighted key events such as bereavements or birthdays, and celebrations including religious festivals.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and family members felt confident in speaking with the registered manager or other members of the management team. They spoke positively of their approachability and openness in listening to feedback and concerns. A family member told us, “I’ve never needed to complain, staff always answer my questions, very approachable. They do a survey, it’s e-mailed.” Another family member said, “They did a survey a couple of months ago, they gave a voucher as an incentive, and I won it!” Results from surveys demonstrated a high level of satisfaction with the service and care provided.

Regular meetings took place for people and their family members. Minutes recorded people’s views were sought on a range of topics, including menus, laundry, staffing and activities. Where people had made specific requests, these were followed up and responded to and documented within the minutes of the next meeting. For example, requests for a barge trip on the canal and theatre.

The provider had a complaint policy which was adhered too, when any concerns or complaints were received. Concerns and complaints were responded to in line with the policy and were part of the provider’s commitment to listening to and responding to feedback, learning from events and incidents as part of the service commitment to a learning culture.

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

People accessed timely care and support. The environment provided facilities which met people’s needs, including equipment to facilitate personal care, such as bathing, aids to assist with mobility and signage to guide them. The external space was accessible to people, providing flat level access from several communal rooms within the service, including for some people their bedroom. The garden had been designed with the needs of people living with dementia, older people and people who had mobility restrictions.

A range of equipment, including a call-bell system and walkie-talkies used by staff meant assistance was provided by staff who responded to people’s needs and requests for support and care. The provider’s quality monitoring system enabled the registered manager to audit call bell response times, and equally the walkie-talkie system was monitored by the management team, to ensure people received co-ordinated care and support.

Records evidenced people had access to a range of health care professionals when required, including emergency services. A member of the management team was on site every day. The management team shared on-call responsibility, providing a point of contact for staff for advice, guidance and support in the event of an emergency or unforeseen situation.

The Business Continuity Plan detailed the actions to be taken in the event of a range of emergency situations, including power failures, loss of water supply, telephone or internet outages, staffing emergencies and adverse weather conditions. The plan provides clear guidance for staff regarding their roles, responsibilities and actions required, including names and contact details for key services to maintain the safety and wellbeing of people.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People’s care plans included clear guidance for staff that showed protected characteristics were considered. This ensured people’s individual needs, such as communication or religious were understood and respected in the delivery of care. Staff were provided with detailed guidance on how to meet people’s needs. Care plans emphasised the significance of people’s well-being and living life to the full. The commitment of all staff in achieving this had enabled people to engage and take part in a wide range of activities, as well as taking on new challenges.

No concerns were raised during this assessment in relation to discrimination. The provider had an equality and diversity policy in place, offering guidance on the importance of treating people equally, underpinned by staff training.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

The commitment of all staff in providing high quality and individualised end of life care was recognised through their achievement of being accredited with the Gold Standards Framework (GSF). The GSF is a registered charity, providing training for staff in caring for people in the last years of life. It provides evidence-based end of life care, to facilitate a ‘gold standard’ of care for everyone, with any condition and in any setting.

People had their advanced wishes regarding receiving treatment if their health deteriorated recorded, and in some instances, this included information as to people’s funeral arrangements. Relatives told us they had been involved in planning for the future, including end of life care. A family member said, “A DNACPR (a document which records people’s advanced wishes should they stop breathing) is in place, and discussed end of life wishes, and agreed for [relative] not be admitted to hospital.”

End of life care plans, as with all care plans were person-centred and reflective of people’s wishes. For example, information as to whether a person wished for their window to be open, how they wished to be dressed and details as to how their bedding was to be arranged. Care plans provided clear guidance for staff as to people’s personal care needs, including oral health, hydration and nutrition, and skin integrity, along with information as to any religious needs. Information of prescribed anticipatory medicines for the management of symptoms and pain was also included and where required were administered by community nurses. Staff contacted nursing staff, providing updates as to people’s symptoms to ensure medicine were administered timely, to be effective.

The registered manager worked closed with a range of health care professionals, including district nurses and G.P.’s to ensure care plans were current and reflective of a person’s condition. Clinical reviews and multi-disciplinary meetings were held for people approaching end of life, and any changes communicated to staff with electronic care records being updated.

People had their advanced wishes regarding receiving treatment if their health deteriorated recorded, and in some instances, this included information as to people’s funeral arrangements. Family members told us they had been involved in planning for the future, including end of life care.

Staff said the quality of end-of-life care was good and that they involved the person’s family. A member of staff said, “We always involve the family. Ensure people are pain free”

The registered manager arranged for staff to visit local funeral directors, which staff were reported to find valuable, and increased confidence in understanding and supporting families.