Brenalwood 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 good. This meant people’s outcomes were good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There had been no newly admitted people to the service since our last assessment. However, the management team told us how they planned to make sure people’s care and treatment were effective because they would be checking and discussing people’s health, care, wellbeing and communication needs with them.

Prior to a person moving into the service, the registered manager told us a needs assessment would be undertaken which would be used to inform people’s care plans and risk assessments, which would be kept under review. The management team told us how they were strengthening the assessment process to reduce previous risks of accommodating people if the service could not meet their complex needs or they were not compatible with the people already living there. This included face to face assessments.

During our assessment, the registered manager told us how they would be undertaking a needs assessment prior to a person returning from hospital to ensure the service could meet their changing needs.

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.

Since our last assessment, the provider had introduced the ‘resident of the day’ system. This included speaking with the person about their views of the service they received, if their needs were being met and any changes they required.

The provider’s policies and procedures included reference to industry recognised good practice guidelines including National Institute for Health and Care Excellence (NICE). The provider kept up to date with changes in legislation and good practice, and these were incorporated into policies and procedures and training.

People’s needs and risks were assessed in relation to nutrition and hydration. Staff we spoke with were aware of people’s specific dietary needs. Improvements had been made in people’s care plans which included a recommended fluid intake for each day. We noted improvements made in how people’s fluid intake was recorded and monitored daily. When low intake was noted by staff, further encouragement was provided to drink. Drinks were accessible to people and offered by staff. Staff had received training in nutrition, hydration and dysphagia.

People were offered choices of meals and if they did not want what was on the menu they could choose to have something else. We saw people had access to snacks, including fresh fruit. People had the opportunity to try different foods and there were themed days, on our first visit it was, “Brownie Day”, people were offered chocolate brownies, but watermelon was also offered for people who chose a healthier option. A person told us, “Food is alright, I like the milkshake every morning.” Another person said, “The food is average, get enough drinks, I like the homemade buns."

The provider 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.

The registered manager told us how they worked with other teams to ensure people received the service they required. This included health care professionals such as the GP, district nurses and Speech and Language Therapy (SALT) team. We spoke with 2 visiting health professionals who confirmed the service worked well with them and the staff knew about the needs of the people they supported.

Staff told us how they worked well as a team. A staff member told us, “The improvements in teamwork have been among the most significant changes. [Registered manager] has encouraged open dialogue, regular meetings, and collaborative problem-solving, resulting in a more unified and effective team.” Another staff member said, “The atmosphere is always positive. Nothing feels overwhelming because we face things together as a team.”

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.

Where staff were concerned about people’s wellbeing, referrals were made to the appropriate health care professionals, this included the GP. Records demonstrated the outcomes to health professionals’ treatment and guidance was incorporated into care plans to make sure people received the care they required consistently. This included guidance received from Speech and Language Therapy (SALT) teams to reduce the risks of choking. Where people required a specific texture of food, we saw this was provided as per their care plan.

People’s records showed they were supported to access services included dentists, opticians and chiropodists. People’s weights were kept under review and actions taken where required when people were at risk of losing weight, including referrals to a dietician and the provision of a fortified diet and high calorie snacks and drinks, such as milkshakes, to help reach and/or maintain a healthy weight.

A relative told us how the staff had identified how their family member’s health condition was deteriorating and acted, “[Staff] noticed it straight away and got the GP in,” in addition, they said they were kept updated. A health care professional told us how they felt the service had improved and referrals were being made appropriately. A person said they did not feel well, and the staff were getting the doctor, the staff had already spoke with the person and an appointment had been made for a visit from the GP surgery.

We saw armchair exercise was on the activity plan, which we observed in practice. People used spongy tubes and raised them above their heads and moved their hands. A person was doing this before prompted which showed they were used to doing this. We saw people were smiling when doing the exercise to show they enjoyed it. When people started to get distracted the activity was ended, which demonstrated their choices were respected.

The provider 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.

Since our last assessment improvements had been made in how the service monitored the care provided. This was ongoing and needed to be embedded in practice and sustained.

A staff member gave an example how a person’s wellbeing had been improved due to the care provided in the service. They told us how a person had come from hospital and had been recommended a softer diet due to a deterioration in their condition, staff told us they had supported the person as guided and noted an improvement in their wellbeing. They had made a further SALT referral, and the person now had normal texture food and drink and had gained weight.

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

Since our last assessment improvements had been made in how people’s capacity to make decisions about their care was assessed and recorded. Where people required support with making decisions in their best interests, this was documents in people’s care records. People’s care plans guided staff to ensure consent was sought from people before providing any care and support. We saw staff doing this during our visits. However, whilst most of the daily notes we reviewed identified people gave consent when personal care was being received, there were some entries which stated that the person had not consented. We provided feedback, and the registered manager assured us they would be speaking with staff about recording and checking staff entries into daily notes and the care provided.

Staff had received training in the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) and themed staff meetings showed these were discussed to support staff understanding. Staff meeting minutes in September 2025 showed staff were reminded to ensure people’s consent was being sought and received when providing care and support.