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This service was previously registered at a different address - see old profile

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Inspection summaries and ratings at previous address


Overall summary & rating

Good

Updated 24 May 2019

We rated Brevin home care as good because:

  • The service had made improvements since the previous inspection in 2017. At the current inspection we found that the service had ensured that all patients had received comprehensive assessments by experienced staff. Since the last inspection, the service had stopped providing alcohol detoxification treatment. The service had recruited nurses, developed a bank system and a log of staff that were available to ensure that patients received care and treatment when they needed it. The service was completing appropriate checks on staff before they commenced employment to ensure they were qualified and suitable to work safely with patients in their own homes. Staff were no longer working excessive hours.
  • At the previous inspection we found that the service did not have a safeguarding children’s policy. In this inspection the service had an up-to-date children’s policy that was easily accessible to all staff. Safeguarding was integral to the teams’ daily practice. Care records demonstrated that staff clearly recorded safeguarding decisions and made appropriate safeguarding referrals where necessary. Staff were aware of who to contact about safeguarding concerns within the team.

  • At the previous inspection we noted that different parts of patients’ records were stored in different places. In this inspection the service had one electronic system with all aspects of a patients’ assessment and care. This was easily accessible to all staff that through a secure log in system.

  • Staff actively engaged with GPs, social services as well as other care organisations, if necessary. This ensured staff could plan, develop and deliver the service to meet the needs of the patients. This included liaison with GPs to ensure physical health checks had been completed.

  • Staff received regular managerial supervision to provide support and monitor the effectiveness of the service.

  • The service had introduced governance systems that included audits to monitor quality of care.

  • The service was well-led by the senior leadership team. Staff had access to information they needed to provide safe care and high-quality treatment to patients.

However:

  • Although the service had an appropriate appraisal policy, non-medical staff had not received appraisals in the past 12 months. Staff appraisals were affected by the high turnover of staff and registered managers.

  • Although staff had care plans for each patient, the quality of care plans varied as some were not personalised according to patient needs. Staff did not always actively promote the needs of all patients, including those with a protected characteristic. Staff did not always include patients’ religion, physical health, ethnicity and sexual orientation into their care planning.

  • The service did not always ensure that discussions and decisions about patient care were always documented.
Inspection areas

Safe

Good

Updated 24 May 2019

We rated safe as good because:

  • The service had made improvements since the previous inspection. The service completed appropriate employment checks on staff and had a system to identify any outstanding checks. The service had sufficient staff and staff did not work excessive hours. Care staff working for the service were bank staff. However, each member of bank staff worked with one client consistently.

  • Staff assessed and managed risks to patients and themselves. When necessary, staff worked with patients and their families to develop crisis plans.

  • Staff kept detailed records of patients’ care and treatment. Records were clear, up to date and easily available to all staff providing care.

  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and knew how to apply it.

  • The service had suitable premises and equipment and looked after them well. Staff kept themselves, equipment and the premises clean.

  • There were appropriate incident reporting procedures. Staff knew the types of incidents to report and how to protect patients from abuse.

Effective

Good

Updated 24 May 2019

We rated effective as good because:

  • Staff completed a comprehensive mental health assessment of each patient that was person centred.

  • The service had working links with other professionals. Staff consistently liaised with patients’ GPs, psychiatrists and psychologists about patient care.

  • The service made sure staff were competent for their roles. Staff received an annual appraisal of their work performance and received regular managerial supervision to provide support and monitor the effectiveness of the service.

  • The service monitored the effectiveness of care and treatment. Staff routinely used outcome measures to see how patients were recovering. Staff measured this in collaboration with patients.

  • However:

  • The non-medical staff has not received appraisals in the last 12 months due to the high turnover of nursing staff and registered managers.

  • The registered manager and consultant psychiatrist had daily meetings to discuss ongoing patient care. However, these discussions and decisions from these were not documented.

  • Staff consistently developed care plans for each patient but some care plans lacked personalisation, such as patient views and specific physical health concerns. Staff did not always identify protected characteristics such as patients’ religion, ethnicity and sexual orientation in their care planning.

  • The service made sure staff were competent for their roles. Staff undertook appropriate specialist training. Medical staff received an annual appraisal of their work performance. The service manager and recovery workers received regular managerial supervision to provide support and monitor the effectiveness of the service.

  • Staff supported patients to make decisions on their care for themselves. They understood the provider’s policy on the Mental Capacity Act 2005 and assessed and recorded capacity clearly for patients who might have impaired mental capacity.

Caring

Good

Updated 24 May 2019

We rated caring as good because:

  • Staff demonstrated a compassionate understanding of the impact on patients’ care and treatment could have on their emotional and social wellbeing. Patients were positive about the care they received from staff.

  • Staff involved patients in discussions around planning their treatment regime.

  • Staff kept in regular contact with patients and ensured families and friends were involved if the patient wanted them to be.

  • Patients were provided with information about the service and what they could expect from staff in their care and treatment.

However:

  • The service had only recently conducted a patient feedback survey and the results to this were unavailable. Patient feedback surveys were not undertaken frequently.

Responsive

Good

Updated 24 May 2019

We rated responsive as good because:

  • The service planned and provided services that met the needs of patients. Staff engaged with secondary care services, patients’ GPs and other health specialists.

  • The service was easy to access and had clear inclusion criteria. Staff responded quickly to urgent referrals.

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

Well-led

Good

Updated 24 May 2019

We rated well-led as good because:

  • The service had good governance processes in place. Clear systems of governance supported staff to learn from incidents and complaints.

  • Managers promoted a positive culture that supported and valued staff. Staff felt well-supported by managers and colleagues. They were positive about the service as an employer.

  • The service was well led by the medical director and the service manager. Staff demonstrated the service’s vision and ethos of the service.

  • Staff had access to information they needed to provide high-quality and safe care and treatment to patients.

Checks on specific services

Substance misuse services

Updated 30 March 2017