Highbury Rise

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 inspection 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 before moving to the service and they felt the staff were able to meet their needs. People and their relatives told us they had enough information and support to ensure the move into the home and the transition went well. We saw staff checking on a person who had moved in the previous day, seeing how they slept.

Staff told us people’s needs were always reviewed and outcomes shared.

Care plans were developed from a preadmission assessment, and through people’s involvement, which included important health, support information as well as people’s preferences and backgrounds. People and their relatives felt involved in this process.

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.

People and relatives said they had enough to eat and drink, sufficient choice and support. A person said, “I have enough to eat.” A relative said, “[Person] is a bit of a fussy eater, but their usual comment to me is 'there is too much food', their weight is monitored and their [health condition] well controlled.” A person did say they felt the menu was repetitive but said the team were working to make changes to the menu. The person told us they could have alternatives if they wished. We reviewed the meal planner and found there to be a varied menu on offer.

The mealtime experience was pleasant, staff were chatting with people and supporting where needed. However, although the food smelt appetising while cooking, development was needed to make it more visually appealing. People gave mixed views about if they enjoyed their meal.

Staff were chatting with people, showing plates of food to help people make a meal choice We saw people’s likes and dislikes were known and staff supported this. We saw there was plenty of drinks offered throughout the day.

There were mealtime experience checks in place and monitoring of people’s dietary needs, preferences and weights. Fortified meals were provided for those who needed them.

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.

People, and their relatives, told us staff knew them well. They told us if they needed any health care input this was sought. A person said, “I can see the doctor, actually they are coming today.”

Staff told us they worked with health and social care professionals to ensure people had the right care and support. This included mental health teams, district nurses and GPs. Feedback from a visiting health and social care professional was positive.

People’s care plans included a record of information obtained on their admission to the home. This was transferred into and informed the care plan.

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.

People and their relatives told us they felt their physical, emotional and social needs were met. They said they had plenty to do to fill their time. A relative said, “The activities on offer allow [person] to participate in art and craft activities, and they enjoy visits from local groups and entertainment.”

Staff we spoke with were knowledgeable about what people enjoyed doing and how to support them to live a healthy life.

Most people were up in communal areas. 2 people were routinely cared for in bed. Staff were going in to support these people to check on them and see if they needed anything. People were being encouraged to join in with activities to help encourage movement and socialisation.

In communal areas, people were listening to music on the TV, having one to one chats, and joining in with a quiz. Another person was painting a gift for their family. People had opportunities to get out and about and there were visiting entertainers and a local school. People told us they enjoyed this. There were events planned based on seasons or important dates. Family members were invited to join in.

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.

People’s care needs were reviewed regularly. There were systems in place to have overview of people’s care needs, wounds and infections for example, and this included progress updates. However, these were not always robust.

Staff were able to explain how they monitored people’s health and wellbeing. They were aware of what action to take if needed. A staff member said, “If I notice changes in someone’s needs or health, I report it immediately and follow the care plan. I am familiar with common signs of infection such as raised temperature, fatigue and behavioural changes.”

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

People told us they were able to make their own choices. We observed people being able to move around the home freely. Relatives felt people had their choices respected.

Staff were aware of the Mental Capacity Act 2005 (MCA). They were able to tell us how they incorporated the principles of the MCA in their day-to-day roles. For example, ensuring choices were offered to people and respected by staff. A staff member said, “I have received MCA training and apply it by supporting individuals to make their own decisions and acting in their best interests if they lack capacity.”

People had consent forms in place for decisions such as staff administering medicines, photographs and sharing information.

Plans were stated where people had capacity to make day to day decisions, but more support was needed for more complex decisions. There was a record when Deprivation of Liberty Safeguards (DoLS) authorisations were requested. A DoLS authorisations tracker was in place so the progress of applications could be monitored. If anyone had conditions imposed for authorised DoLS these were recorded and staff made aware of how to comply with these.