Braintree Nursing Home

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

We reviewed 4 quality statements under this key question: assessing needs, delivering evidence-based care and treatment, monitoring and improving outcomes and consent to care and treatment. We found that people were involved in their care and their consent to receive care was sought by staff and the management team. Where people could not consent to care, the appropriate legislative processes were followed. People had their needs assessed before care commenced and expressed how they wished their care to be delivered. People were supported to have their nutrition and hydration needs met. There were effective approaches to monitor people’s care and treatment and their outcomes.

This service scored 75 (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 admission to the service. A relative told us, “[Name] has been here for a few months now, the staff are lovely, patient, and sweet. The communication is very good at all times.”

Staff had a good understanding and knowledge of the people who lived at the service. They were able to tell us about the care they provided for people. One member of staff told us, “I prefer to move around the home, so I am aware of all the people’s needs and how to support them.”

The service used an electronic care plan system. Each person had their own personalised care plan which was reviewed with the person or their representative monthly or sooner if their care and support needs changed.

People’s care, treatment and support was delivered in line with good practice standards and their nutrition and hydration needs were met in line with current guidance. We observed staff offering people choices around their daily support. People told us they enjoyed the food on offer. Comments included, “It is good, there is always something to eat when I need it.” And “The food is ok, I eat all the meals, we get enough fruit, vegetables, biscuits, sandwiches and hot drinks they always do that for me.”

Staff confirmed they had the skills and knowledge to carry out their roles effectively. They completed a range of training and information sharing was disseminated to staff through supervision sessions and team meetings. The deputy manager told us, “We have good contacts with external health professionals who provide a range of training sessions to staff such as, stoma and catheter care, dysphagia, skin integrity and dementia training.”

Care plans contained evidence of involvement of a wide range of external professionals. There was guidance around people’s nutritional needs and people’s diets were appropriately monitored by recording their daily food and fluid intake. Where risk of choking or malnutrition had been identified referrals had been, made to speech and language therapists (SALT) and dietitians. Their recommendations were documented in people’s care plans and clear information provided to the kitchen staff to ensure people received the recommended modified/fortified diet.

Staff worked with other agencies to provide effective care. This in turn supported people to live healthier lives.

Although new to the area the registered manager had established good relationships with health and social care professionals to ensure people received effective care and support. Staff were proactive in developing and maintaining relationships with external agencies. They worked closely with health and social care professionals, including GP's, district nurses and social workers to achieve good outcomes for people.

The service worked collaboratively with a variety of health and social care professionals. When staff had identified concerns, referrals had been made to the appropriate professional. For example, one person had been coughing when drinking. Staff had promptly referred them to the Speech and Language Therapy Team (SLT) for a swallow assessment. When people had received input from health professionals this was clearly documented in their notes along with any specific instructions or guidance for staff to follow. One visiting healthcare professional told us, “We are more than happy to address their concerns. I have got no concerns here.”

Care plans were up to date and reflected people’s needs. They contained clear guidance for staff about potential day to day risks to people and how to minimise them. A system was in place to ensures care plans were regularly reviewed, if a person’s needs changed the review date was brought forward.

Before people moved into the service, an initial assessment was completed to ensure the service could meet their needs. People received personalised care, tailored to meet their needs, and enhance their lives. A relative told us, “The staff look after them and they tidy them up and they do not ignore them, they are comfortable enough, there is nothing I don’t like about the place.”

Staff knew people well and treated them as individuals. A staff member told us, “We find out about people’s needs before they come to us.”

Visiting healthcare professionals praised staff for the support they gave people and the positive impact it had upon their lives. Comments included, “Staff know people, I have no concerns about this home, I am happy with the support.” And “They are very pro therapy, carrying out our advice and exercises and are very onboard.” Systems were in place to ensure any recommendations made by visiting healthcare professionals were clearly documented in people's care plans and communicated with staff. This meant people received individualised care and support that was responsive to their needs.

There were effective approaches to monitor people’s care, treatment, and outcomes. People received good outcomes because of the support provided to them. A relative told us, “[Name of person] is a lot better than when they first came. They had remained in bed for the first 1 or 2 weeks but now they go downstairs and have been improving all the time.”

Staff spoke about the people they supported with compassion and respect. They knew about people’s life histories and interests and built trusting and rewarding relationships with people. The delivery of care was flexible and empowered people to make choices about how and where they received their care. Staff understood the values of person-centred care and supported people to attain their goals.

Care plans were reviewed regularly as part of the registered manager quality assurances processes. People and/or their representatives were involved in care reviews and invited to attend resident and relative meetings.

Staff were respectful to people and gained consent before attempting to provide support. For example, a member of staff entered a person’s bedroom by knocking with a drink and a snack. They communicated with the person informing them why they were there, asked if they could assist them into a more comfortable position by asking, ‘Can I lift your head up or are you able to do it?’ They offered the person encouragement and gave them time to respond.

Staff were aware of the Mental Capacity Act (MCA) and were able to describe how they apply this in their day-to-day practice. One member of staff told us, “If people have capacity, they have a right to refuse, and we have to respect their decisions. Where people lack capacity, we involve their family when discussing decisions.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service had assesses people’s capacity and where a person deemed to lack capacity had completed the relevant applications for people and sought legal authorisations to deprive a person of their liberty where required. Although MCAs had been completed for people to determine their capacity it was not always clear of the involvement from a person’s representative. The registered manager and deputy manager told us they would be reviewing these following our on-site assessment visit.