Brunel House

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

Managers completed assessments of people’s needs before they were offered a place in the service. The registered manager told us only the senior management team completed assessments but at times the dementia ambassador was involved. The dementia ambassador was a designated member of staff who had received additional specialist dementia training. Including this member of staff in initial assessments of people’s needs enabled them to start collecting information about people’s circumstances and life history. Assessments included details of people’s health conditions, communication, social and emotional needs. People and their representatives were involved in the assessment process.

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.

The provider used nationally recognised tools to assess people’s needs in relation to hydration and malnutrition. Details of people’s needs were included in their care plans and records demonstrated staff followed these plans.

We observed staff providing effective support and encouragement for people to eat safely and maintain their nutritional intake. Kitchen staff understood nutritional needs and could talk confidently of allergies and dietary requirements. Staff completed training in nutrition and food safety to ensure their knowledge was up to date. Management and senior staff completed mealtime experience audits to observe people’s experience. This helped ensure people were having choice and a positive experience. People’s feedback about the food was positive.

Specialist staff from the providers wider team regularly visited the service to offer extra support and guidance. For example, a regional executive chef supported kitchen staff with food and nutrition. A regional dementia manager also visited regularly to provide advice and support staff with dementia care.

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.

Care records demonstrated the provider worked closely with other professionals to ensure people’s needs were met. Examples included GPs, the palliative care team, community nurses and the mental health team. Information was shared with other professionals when needed to ensure people received joined up care.

Staff had regular handovers before the start of their shifts. This kept them up to date with any changes in people’s needs and any other events or incidents. There was also a daily head of department meeting. This brought all heads of department together to discuss information such as complaints, admissions and safeguarding. This enabled all teams in the service to receive and share information in a timely way.

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.

Records demonstrated people were supported to access a range of health and social care services. These included GP, community nurses, the palliative care team, speech and language therapists and social workers. Staff escalated any changes to people’s health to the relevant healthcare professionals and made sure people’s health needs were reviewed if needed.

People were involved in reviewing their health needs regularly. There were monthly reviews of care plans which included discussions with people about their health needs.

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.

Staff maintained records of care they had provided, for example, how much food and fluid people had taken, observations of people’s level of distress and observations of people’s skin conditions. Records demonstrated changes were shared with health and social care professionals to ensure people received appropriate treatment.

The provider had systems which enabled various levels of staff to monitor information about people’s health and wellbeing. For example, weight loss, falls and pressure area care were regularly reviewed to help improve outcomes for people.

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

Records demonstrated people had consented to their support plans. People were involved in initial assessments and included in reviews which helped to make sure their wishes were respected and considered. Where people lacked capacity, an assessment had taken place and decisions made in people’s best interest. The legal framework for this process had been followed and all relevant actions were recorded.

Staff had training on the Mental Capacity Act (2005) and were aware of the importance of obtaining consent before providing any care.