Brook 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

The provider had not always ensured decisions around people’s capacity to consent were documented accurately, in line with the Mental Capacity Act 2005. However, we found people were able to make choices about their daily care. The provider had not always ensured people had detailed assessments of their needs completed when moving into the service. However, staff and managers had engaged with people, relatives and professionals to build upon the initial assessment and promote people’s health and wellbeing to achieve good outcomes. People’s nutritional and hydration needs were assessed and managed appropriately.

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.

People's needs were assessed prior to them receiving care; however, these assessments were not always detailed. The provider used the information in people’s initial assessments to develop personalised care plans; however, not all relevant information had been included in the care plans for people who were newly admitted to the service. This meant there was a risk staff may not have the appropriate guidance in place to understand people’s individual support needs and preferences. We received mixed feedback from people’s relatives about their involvement in the assessment process with some relatives feeling they were not consulted and others feeling involved throughout.

Staff and managers told us people’s care records were reviewed to check they remained an accurate reflection of people’s needs. Following our feedback, the management team told us they were implementing additional checks to ensure all relevant information was in place where people were new to the service. The registered manager told us they were also reviewing how well people and those important to them were involved in assessing and reviewing care and were making improvements to their engagement processes.

The provider's processes for assessing people's care and support needs were not always robust. People's care plans contained an initial assessment of their needs. However, this information did not always contain all relevant information. Where information was missing, this had not always been identified promptly to ensure action was taken.

People and relative spoke positively about the quality and variety of meals and snacks available at the service. People had drinks readily available and were encouraged to drink fluids regularly. Where appropriate, the provider had made referrals to relevant health professionals to meet people’s individual health needs including their eating and drinking support needs.

Staff were able to tell us how they supported people with their eating and drinking support needs and promoted choice in this area. The management team told us they were in the process of sourcing more specialised, in depth training for staff to ensure they fully understood people’s individual needs including the experiences of people living with dementia and people with a learning disability and autistic people

The provider had processes in place to monitor people’s nutritional and hydration needs. The provider had systems in place to share up-to-date information about good practice guidance with staff. Examples of training opportunities, learning and updates were shared with staff via team meetings and supervisions.

People’s care plans contained information about their health and care needs and who was involved in their care. This meant information was available and ready to share across services to enable people to receive consistent care which met their needs and preferences.

Staff were able to tell us about people’s care and support needs and where to access guidance about how they wanted their care delivered. The management team told us they regularly worked with a variety of health and social care services to support people's needs

We received generally positive feedback from health professionals involved with the service about how well staff and managers knew people and understood which services to engage with to support their needs as required.

The provider had processes in place to ensure information relating to people’s needs was available for staff and other health professionals working with the service.

People were encouraged and supported to make healthy choices and maintain their health and wellbeing. People's health needs were reviewed, and appropriate input was sought from other health professionals when required.

Staff supported people to attend their health appointments and checks and responded to changes in people’s health needs. Staff and managers understood the importance of promoting people's health and wellbeing.

The provider had processes in place to ensure referrals were made when necessary and health appointments were attended. People's care plans contained information about how to promote their health and wellbeing.

People's care was monitored and reviewed to promote good outcomes. The provider was in the process of making improvements to how they sought feedback from people and relatives to ensure they were more involved in monthly reviews of the care provided and were consulted in suggesting improvements and planning good outcomes.

Staff were able to explain how they monitored people’s care and what they did if they had any concerns. The management team provided opportunities for staff to meet regularly and discuss people’s care. Managers signposted staff to updates and changes in people’s care.

The provider had processes in place for monitoring people's care and improving outcomes. People’s care documentation was reviewed to ensure it met people’s changing needs. The provider was in the process of planning more in depth reviews with people and those important to them to promote better planning and reviewing of outcomes.

People’s consent to care and treatment had not always been clearly documented in their care plans. People’s mental capacity assessments were not always detailed and did not reflect who had been involved in the decision making process. Where restrictions were noted in people’s care plans, it was not always clear how the decision had been reached or who was consulted. This meant it was not clear how people or those important to them had been involved in making decisions about how they wanted their care to be provided or what was in their best interests. Despite these concerns, we observed staff offering people a variety of choices about their care and responding appropriately to people’s requests and decisions.

Staff told us they had received training in understanding the Mental Capacity Act [MCA] and understood people's right to make their own choices and decisions where possible. The management team responded promptly to our feedback about the quality of the capacity assessment documentation and told us they would arrange prompt reviews of the assessments with people and those important to them.

The provider's processes for assessing and documenting people's consent to care were not always effective. Documentation was not always completed well and lacked information. However, the provider had submitted Deprivation of Liberty Safeguards (DoLS) applications when appropriate and kept a tracker to ensure updated applications were made as and when required.