Brookview Neurological Centre-Inspire Neurocare (Worcester)

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 67 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Some staff and professionals told us people’s needs were not always pre-assessed and shared with staff team ahead of people’s admissions. One healthcare professional told us, “On various occasions, I have asked nursing staff the reason for a patient’s admission and where they have come from etc, to be told they don't know. Staff tell me they are often told that someone is coming into a certain room on the day and learn more on admission. The person doing the core assessment and accepting the patient’s needs to ensure staff know about the patient before entering the building to improve patient care and journey.”

Another professional told us, “There is currently no involvement of therapists in the initial assessment. Therapists would be far better positioned to liaise with the therapist in the original setting, aware of guidelines and evidence base for therapy and thus determining the therapy hours, however this would likely result in the need for additional therapy hours so increased staffing would be required.”

We raised this with the leadership of the service, and we were told the acting manager recognised this issue and reported it to the head office. They told us this was a historical issue caused by multiple admissions in a short period of time. Since then, new admissions were stopped to ensure proper assessments of people’s needs, and weekly meetings with head office took place to discuss discharges and occupancy.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. The care and treatment was not always delivered in line with legislation and current evidence-based good practice and standards.

One healthcare professional told us, “The admission documents do not appear to be based on guidelines for example the RCP Stroke Guidelines (2023) recommend 3 hours per day of therapy, 5 days a week post stroke, I have never seen an admission assessment for anyone with a stroke diagnosiswhere the total therapy hours are anywhere close to 15 hours of therapy a week.”

A staff member told us, “I just get told people are coming in and these are the hours. Sometimes they just arrive, they are not communicating the needs, the hours and asking if we can meet them. We are trying to do a job which is unachievable.”

We raised this with the leadership of the service, and we were told that the acting manager recognised this issue and reported it to the head office. They told us this issue was caused by multiple admissions in a short period of time. Since then, new admissions were stopped and weekly meetings with head office took place to discuss discharges and occupancy and ensure appropriate pre-assessments and treatments were in place before people were admitted to the service.

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.

People confirmed they were supported to attend appointments with professionals, which promoted coordinated care and ensured their voices were heard. Records showed people accessed a range of health and social care professionals, such as GPs, social workers, occupational therapists, and psychologists. One person told us, “I have physio for my mobility 3-4 times a week, psychology and occupational therapy 1-2 a week. I cook, wash dishes, noticing an improvement 100%. The attention here is more than hospital, I'm pushed more, when done I feel so accomplished.”

When asked about who deals with doctors, dental or optician appointments all people’s relatives replied the service take care of all this and there have never been any issues.

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.

Relatives told us staff supported people with their health and oversaw people’s health appointments to ensure these were not missed.People told us they were supported to access health care services and treatment when needed. Staff monitored people’s health and carried out routine observation and weights were measured regularly to identify any changes. Care records showed staff worked closely with health professionals to coordinate care effectively. Staff knew when people were unwell or in pain, discomfort or showing signs of an infection and supported people to access health care services for their health care needs.Daily handovers were being completed. Records included information about people and information reviews by professionals, the care provided, meals and the involvement of professionals.

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.

The majority of people and relatives fedback that living in the service had had a positive impact on them. One person’s relative told us, “I think the nursing team and staff are fantastic. I do think they are safe there and I do think that the staff really want to do their job well.”

Information about people, their care and changes in needs and choice was recorded in the electronic system. Food and fluids records were seen along with weights and MUST scores. Daily records detailed each activity undertaken by staff with the person, however, we saw some gaps in daily logs. The gaps were identified by the service provider and as a result staff were reminded to accurately complete daily records and records related to monitoring people.

People’s care plans were regularly reviewed and updated following assessments, hospital discharges, or changes in health.

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

Staff understood the requirements of the Mental Capacity Act and associated codes of practice. They appropriately completed capacity assessments and ‘best interests’ decisions.Where people had Deprivation of Liberty Safeguards (DoLS) authorisations in place, this was clearly recorded. Applications awaiting authorisation had been followed up appropriately to check on progress and ensure people’s rights were protected.

Staff sought consent from people before providing care and support. They explained what they were doing, offered choices, and respected people’s decisions. This helped ensure care was delivered in line with legal requirements and with respect for people’s autonomy.