Bradley Complex Care

Updated 19 May 2022

Bradley Complex Care is a high dependency long stay rehabilitation hospital provided by Elysium Healthcare (Healthlinc) Limited. The hospital, located on the outskirts of Bradley village near Grimsby, provides care and treatment for male and female people that have learning disabilities and complex conditions such as a personality disorder, mental health problems and autistic spectrum disorders. People are admitted to the hospital from throughout the country.

The accommodation consists of 20 beds in eight separate apartments surrounding a central courtyard.

The hospital is registered to carry out the following regulated activities:

• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Treatment of disease, disorder and or injury

At the time of the inspection, the hospital had a registered manager who had been in place for seven months. There were 16 people at the hospital, all of whom were detained under the Mental Health Act.

We last inspected Bradley Complex Care in November 2019. At that time, the service was rated overall good. We rated good in the effective, caring, responsive and well-led domains. We rated the safe domain as requires improvement due to concerns at that time. On this inspection, we found that the service had addressed these concerns.

What people who use the service say

During our inspection, we spoke with 11 people using the service and the relatives of six people.

People told us they felt safe at the hospital. They liked the staff and the apartments that they lived in. Most people were able to tell us about their care and what their goals were. They could describe what their positive and negative behaviours were and the impacts of both. One person was proud to tell us how their positive behaviours had reduced the number of times staff needed to restrain them. People

told us how they got involved in activities, which included planning their meals and how they regularly had trips outside the hospital.

Most relatives we spoke with lived a long distance from the hospital which meant they were unable to visit as regularly as they would like. However, when they did visit, they felt safe. Staff made sure they kept in regular contact through telephone and video calls. Most relatives felt involved in the family members care and received invites to meetings. They said that the doctor’s communication was thorough explaining medications clearly. They said staff were warm and friendly. One relative informed us that they previously had routine reports about their relative. However, they felt more recently that they only received these if asked and felt contact could be improved. Three relatives had concerns about their relative’s weight changes, however they told us the hospital were addressing these.

Updated 19 May 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

• The service supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.
• The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.
• Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced.
• The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment.
• People had a choice about their living environment and were able to personalise their rooms. The service made reasonable adjustments for people so they could be fully in discussions about how they received support.
• Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care

• The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
• People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
• People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
• People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.
• Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

• People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.
• People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.
• Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.
• People and those important to them, including advocates, were involved in planning their care.
• Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

Our rating of this service stayed the same. We rated it as good because:

• People’s care and support was provided in a safe, clean, well equipped, well-furnished and well-maintained environment which met people's sensory and physical needs.
• People were protected from abuse and poor care. The service had sufficient, appropriately skilled staff to meet people’s needs and keep them safe.
• People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood each person’s individual needs. People had their communication needs met and information was shared in a way that could be understood.
• People’s risks were assessed regularly and managed safely. People were involved in managing their own risks whenever possible.
• If restrictive practices were used, there was a reporting system in place and there were comprehensive reviews to try and reduce the use of these practices.
• People made choices and were supported to take part in activities which were part of their planned care and support. Staff supported them to achieve their goals.
• People received care, support and treatment that met their needs and aspirations. Care focused on people’s quality of life and followed best practice. Staff used clinical and quality audits to evaluate the quality of care.
• The service provided care, support and treatment from trained staff and specialists able to meet people’s needs. Managers ensured that staff had relevant training, regular supervision and appraisal.
• People and those important to them, including advocates, were actively involved in planning their care. A multidisciplinary team worked well together to provide the planned care.
• Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.
• People were in hospital to receive active, goal-oriented treatment. People had clear plans in place to support them to return home or move to a community setting.
• Leadership was good, and governance processes helped the service to keep people safe, protect their human rights and provide good care, support and treatment.

However,

• People’s physical health conditions were not always escalated appropriately.
• People’s ongoing physical health checks required after administration of rapid tranquilisation were not always carried out or documented correctly.
• People’s privacy and dignity was not always maintained when they were given their medications.
• People’s positive behaviour plans were not in an easy read format.

Updated 5 April 2018

Updated 19 May 2022