Archived: Brevin Home Care

Updated 24 May 2019

Brevin Home Care provides treatment and nursing care to patients who have mental health problems, in their own home. Care and treatment are provided on a short or long term basis. Depending on patients’ needs some input is provided by a support worker, psychological wellbeing practitioner, registered mental health nurse or a psychiatrist. The service provides nursing care to a maximum of 15 patients at any one time. At the time of this inspection, Brevin Home Care was providing treatment to 14 patients. Patients or their families fund the cost of services provided by Brevin Home Care. Brevin Home Care offers additional support for patients who are under the care of secondary services and treated in hospital who wish, and are able, to be discharged home. They also offer support for those that are having outpatient treatment with a practitioner such a psychiatrist or psychologist. In the last inspection the service was providing detoxification from drugs/alcohol, however in this inspection the service no longer provided detox services.

Brevin Home Care is registered to provide the regulated activities: Personal care; Diagnostic and screening procedures; and Treatment of disease, disorder or injury.

Brevin Home Care has a new registered manager at the service that has been in the role for three months. We have inspected Brevin Home Care three times since 2010.

At the last inspection in January 2017, Brevin Home Care was in breach of three regulations: Regulation 12 safe care and treatment; Regulation 18 safe staffing; and Regulation 19 fit and proper persons employed.

At the inspection in 2017, we found one patient was not comprehensively assessed prior to commencing care and treatment. Staff did not undertake a risk assessment of every patient during the initial assessment, including where appropriate details of the patient’s current and past substance misuse and physical health histories. There was no record that patients had a medical review during alcohol detoxification. In addition, we found gaps in checks carried out on prospective new staff, a shortage of qualified staff and staff working excessive hours.

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.