Bramshaw House

“This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.”

“We assessed the service in line with CQC’s ‘Right Support, Right Care, Right Culture’ best practice guidance to judge whether people received respectful, dignified, and person-centred care that promoted their independence, choices, and inclusion in the community. The provider was working in line with national best practice guidance for supporting people with a learning disability and autistic people.”

“People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives.”

“People, their relatives and those important to them told us they were involved in MCA assessments and best interest decisions and there was evidence of this. For example, the decision to fit a Percutaneous Endoscopic Gastrostomy (PEG) tube when a person was unable to swallow safely and maintain sufficient oral intake. Feedback received from a person’s court-appointed representative informed us they felt appropriately involved in decisions about a person’s care. A relative told us that, when their loved one experienced serious health issues, they were involved in best interests’ meetings with staff and medical professionals to discuss and agree the most appropriate way forward. This demonstrated relatives were involved in important decisions about their loved one’s care and treatment.”

“People received safe, effective and well-planned support that reflected best practice guidance for people with a learning disability and autistic people. People were supported by enough suitably skilled staff, with safe recruitment processes in place. A family member told us, “The selection of good staff seems to be a strong point of the home.” Risks were assessed, managed and reviewed, and people were involved in decisions about their safety. Effective systems were in place for safeguarding, medicines management and environmental safety. Care plans provided clear guidance to staff to support people safely, including how to respond to epileptic seizures and complications associated with PEG and stoma sites, and when to seek medical advice. Staff had received appropriate training to support people’s needs well, including training required to support people with a learning disability.”

“Systems were in place to assess, monitor and review people’s care and changing needs. People had timely access to healthcare professionals and routine health screening to support their health and wellbeing. Referrals were made promptly…”