The Coach 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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to admission, and the support required from staff. This clearly informed their care plans which highlighted the person’s identified needs, planned outcomes and how they were going to achieve those outcomes

Care plans also detailed people’s preferences, likes and dislikes, supporting staff to deliver personalised, person-centred care.

We saw people’s care plans and risk assessments were regularly reviewed to ensure they remained up to date and reflective of people’s current needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff worked with people and professionals, including, monthly reviews with the dietician and diabetic nurse to support people around healthy eating and dietary requirements.

People’s care plans included details around nutrition, oral hygiene, diet and well- being as well as a MUST review carried out monthly. [The 'MUST' (Malnutrition Universal Screening Tool) is an assessment tool used to identify adults who are malnourished, at risk of undernutrition, or obese].

It was documented in 1 persons’ care plan, that their planned outcome was for them to understand how their diet and nutrition impacts on their physical and mental health as well as to improve their quality of life. Staff supported them to be able to prepare and eat healthy options to keep their diabetes under control and prevent or minimise risk of them developing illnesses and conditions related to diabetes and poor nutrition.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had daily handovers, held regular team meetings and external multidisciplinary meetings to monitor people’s progress and where needed formulate different approaches.

People received care from staff, different teams and services, which was well co-ordinated and positive in delivering the care and treatment needed. An example of this was ongoing monthly reviews with the dietician and diabetic nurse to support people with healthy eating and dietary requirements.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Positive relationships between staff and people meant support was provided in a meaningful way to manage their health and wellbeing.

People’s health was regularly monitored through reviews. These reviews included the areas such as their dietary needs, weight and mental health changes where people were identified as being at risk in these areas. Care records showed people had accessed a variety of health care professionals such as; dentists, opticians, GPs and mental health teams.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Staff described how they supported people to identify and achieve their goals. People told us how staff supported them to achieve positive outcomes. For example, a person told us how staff supported them with managing a difficult health diagnosis, supporting them throughout treatment and ongoing management of this condition. Staff worked collaboratively with medical practitioners, specialist teams, and other healthcare professionals to ensure a coordinated approach to this care and continued to monitor the person after successful treatment concluded.

However, people’s goals and their progress with achieving them were not always meaningfully documented or reviewed. For example, 1 person’s goal with their mental health was noted as, ‘To have a good quality of life, living as independently as able to in a safe and therapeutic way.’ This goal was not broken down into areas that could be effectively monitored on review to demonstrate how this was being achieved. There were tasks to be completed, for example attending one to one session’s and maintaining contact with health professionals. However, the assessment did not identify what a good quality of life looked like for this person and how independent this person could be. This meant there was a risk people may not achieve the outcomes identified to realise and achieve their goals. The registered manager and operations manager told us they were aware of this gap and were planning to address this through additional training for staff and mentoring by the management team.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The registered manager and staff team were knowledgeable about MCA and DoLS and worked within the principles of the MCA. Where people lacked capacity to make decisions, appropriate people were involved in making decisions in people's best interests.

Staff had received training in the MCA and were able to describe how they gained consent. Records in relation to peoples’ capacity assessments were present in their entirety in the peoples’ care plans. Where restrictions were placed on people’s freedom, for example not leaving the building alone, the appropriate DoLS authorisation had been sought, and people were supported to access the community. However, as reported, staff did not review those conditions as part of regular planned care reviews. The registered manager took action to ensure staff included this in future care reviews.