Bracebridge Court

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

People’s needs were assessed prior to moving to Bracebridge Court. This ensured the service could meet people’s expectations to support positive outcomes. People and relatives were confident the support they received met their needs from the outset. A relative said, “It was from the hospital to here, they were involved in the referral with us.” They were confident their relative was well looked after. Assessments formed an essential part of people’s care plans which were further developed from feedback from staff and relatives once care commenced. One staff member was in the process of admitting a person to the home and explained, “It will be a basic care plan for now and over the next couple of days we will build on the care plan and get as much information as we can from the family." People’s care plans were reviewed monthly through a ‘resident of the day’ system to ensure they remained relevant and effective.

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.

Staff understood the national recognised tool used to determine a person’s food and fluid consistency so they could eat and drink in a safe way based on their individual needs. Staff described to us 1 person who needed 1 scoop of thickener in their drinks. The person’s care plan confirmed this. Staff completed individual food and fluid charts, but we recommended staff also recorded the meal that was given. We saw examples where some information about a person’s food consistency was recorded slightly differently in the care plan and on their food charts. The registered manager took action to address this. However, our conversations with staff showed they knew the correct consistency of people’s food and drinks.

People's individual risks were assessed using recognised assessment tools, such as the Waterlow Score to assess risks of skin damage. Staff received regular training to promote practice that reflected up to date guidance. Some staff explained how they used their dementia training to provide care that was reflective of people’s individual and unique presentation.

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

Staff described good communication to ensure people’s needs were met safely and effectively. During our inspection we saw staff liaising to ensure a staff presence was maintained in a communal area to help make sure people received support when needed. Staff felt they worked well with each other and were complimentary of management. Care team leaders managed the shift and worked well with care staff on the floor. One care team leader told us they had 1 care staff member call in sick, so another care team leader released one of their care staff to help on the other floor.

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 wherepossible, reduce their future needs for care and support.

People were supported by staff to have access to services to promote their health and wellbeing. These included GPs, prescribers and district nurses. People and relative said they saw external professionals that supported them to live a healthy life as possible. One person told us, “I have had an eye test from Specsavers.” A relative said, “We took [Relative] to a diabetic screening to do with her eyesight. Specsavers came in and did her hearing and there is a doctor here.” This relative went on to say, “They (staff) deal with her lack of hearing in a compassionate manner.” Staff offered people regular opportunities to engage in physical activity to promote their mobility and balance. Some people and relatives said they took part in regular exercise sessions which helped maintain their freedom of movement. Opportunities for meaningful engagement both inside and outside the home improved people’s emotional and social wellbeing.

The provider did not always routinely monitor 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.

Records were kept for monitoring people’s food and fluid intake, catheter care and when people needed to be repositioned to prevent skin damage. However, we found unexplained gaps in some monitoring records. For example, staff were not always recording 1 person’s catheter care although this was detailed as a requirement in their care plan. Records did not evidence another person was being repositioned in accordance with their planned care. Other records for food and fluids did not consistently record how a person had their drinks and meals modified. Improved oversight of daily records was required to ensure monitoring records were completed accurately and consistently.

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

People’s rights were upheld and their wishes and consent were consistently considered. One person said, “They (staff) always ask me first and explain what they are doing.” Another person confirmed this saying, “Staff definitely always ask for my consent when they help me, we always get a choice of two meals, and they show the plates.” One relative shared their positive experience around choices. This relative said, “[Relative] is free to do what they like; I have seen them taking her to her room when she’s asked to go.”

Care plans reflected when people had capacity to consent to their care and treatment and how staff should support people to make as many of their own decisions as possible. Where people had health conditions that impacted on their ability to make their own decisions, capacity assessments had been completed. Assessments reflected how others involved in people’s care had been consulted to ensure decisions were made in people’s best interests, including where people needed their medicines disguised in food or drink. Staff offered people choices and respected people’s right to decline support. They told us they would encourage people to accept support, offering it at different times to reflect people’s personal routines and preferences. One staff member told us, “You can't force them to do anything. They still have freedom of choice. You can advise them and say I will come back.”