Brailsford 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 the last inspection this was rated good. At this inspection it had changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people’s needs were effectively assessed. When people moved into the care home, there was a pre-admission assessment to consider their needs. However, we did not see that regular reviews with the person (or their family) had then occurred. We saw some care plans did not provide enough guidance on how to provide effective care. For example, 1 person could become distressed, and the care plan described how staff could give them medicine ‘as needed’. However, the care plan did not provide enough detail on non-medical approaches to resolve the person’s distress. People felt that staff knew them well and staff members explained they knew how to support people. However, poor care planning meant people could not be assured of effective care if supported by new or unfamiliar staff, as guidance was not in place.

Care plans did not always include national guidance for staff. For example, one person had a diagnosed health condition. The NHS provides guidance on how to monitor this diagnosis, however this national guidance had not been reflected in care planning. While care plans did not always provide evidenced based guidance, the service did effectively use national tools to assess risk. For example, the service used a nationally recognised malnutrition tool to assess a person’s risk of weight loss and ensure they received appropriate support to reduce the risk of malnutrition. We saw people received enough food and people told us that they always had enough to eat. The kitchen staff had guidance on people’s different dietary needs to ensure their nutritional needs were met effectively.

The provider held regular meetings and supervisions with the staff team. However, staff felt that the meetings and supervision were not always effective. We also found three referrals had not been made to the local safeguarding team. Other than this feedback, we saw the service worked well with external teams to effectively support people. There was evidence that referrals had been made to different health professionals as needed. Staff felt they worked effectively with external professionals. A staff member explained what documents they used to ensure visiting paramedics have all the information they need about a person.

People were supported to stay healthy by being as mobile as possible and eating a healthy diet. People received referrals to health professionals to ensure that their health needs were met.

The service did not clearly record people’s health needs in their care plans. This meant there was a lack of guidance for staff, to monitor the person and improve their outcomes. While care plans did not always provide clear guidance, people explained they felt staff knew them well. Staff kept clear records on the type of support people received each day. This record keeping allowed staff to recognise how a person’s needs had changed and then take appropriate action to ensure the person had good outcomes. For example, a person showed changes in their toileting needs. This was recognised by staff and the person was referred to health professionals (who prescribed antibiotics for a urine infection). This meant the person’s health improved and led to a good outcome.

People were told about their rights around consent and respected these rights when delivering person-centred care and treatment. Some people were unable to consent to their care due to their mental health condition. There were clear processes to support these people in line with their known values and in their best interests. A staff member told us “We explain everything to the residents before carrying out any care.”