Kathryn's 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 67 (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 reviewed regularly to ensure care continued to reflect their changing needs and preferences. Assessments considered people's physical health, mental health, mobility, communication and support requirements, helping staff to deliver personalised care. Care records contained information to guide staff in meeting people's needs safely and effectively. While some opportunities were identified to further enhance the detail recorded within assessment documentation, people’s needs were understood, reviewed and used to inform the care and support they received.

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 received care and support that was informed by recognised best practice guidance and evidence-based assessment tools. The service used nationally recognised tools, including MUST (Malnutrition Universal Screening Tool) assessments to monitor nutritional risks and Waterlow assessments to identify and manage risks associated with skin integrity. Where risks were identified, appropriate care planning and interventions were implemented. The manager demonstrated an awareness of the importance of keeping up to date with current guidance and best practice to ensure people received safe, effective and person-centred care.

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.

Staff worked effectively together to ensure people received coordinated and consistent care. We observed records of comprehensive handovers between shifts, which enabled important information about people's needs, risks and wellbeing to be shared in a timely way. One member of staff said, “[New] staff do shadow shifts, what I normally do is go through the care plans, how to do personal care. I do a step by step with staff.”

Staff told us communication within the team was good and records reflected a collaborative approach to care delivery. The service also worked proactively with a range of external health and social care professionals, including GPs, community nurses and specialist teams, to support people's health outcomes and ensure their needs were met. An external professional told us, “[There is] pretty good communication, [member of senior staff] calls a lot.” This helped to promote continuity of care and a joined-up approach to supporting people.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Where people had identified food preferences to support weight gain, records did not always demonstrate these foods were consistently being offered. We also found kitchen staff were not fully aware of their responsibilities in supporting people living with diabetes or the dietary considerations associated with this condition. We fed this back to the management team, who recognised the need to strengthen staff knowledge in this area to ensure people received appropriate support to manage their health needs.
However, people were supported to maintain their health and wellbeing. One person told us, “If you need a doctor, you can always ask to see one, you can be put on the list for when they visit.”

We received positive feedback about the quality of the food provided. One person told us, “The food is lovely.” People told us they enjoyed the meals available and had choices that reflected their preferences. Nutritional risks were monitored, including for people experiencing weight loss, and referrals to relevant health professionals were made when required.

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.

We found one person had been assessed as requiring food and drink to be offered on an hourly basis due to concerns about their nutritional wellbeing. However, records suggested this was not always happening consistently and this had not been identified by leaders when monitoring the outcomes. We raised this with the manager, who acknowledged the issue and agreed to review monitoring arrangements to ensure care was delivered in line with assessed needs.

Despite this, systems were in place to monitor people's health, wellbeing and care outcomes, and care records generally demonstrated that changes in people's needs were identified, reviewed and responded to appropriately. A relative told us, “I have honestly never seen such a huge improvement in [their family member] in such a short time; her mental health, her emotional well-being, she's made friends, her eating habits have become more normal, I cannot stress enough how wonderful they have been.” Referrals to healthcare professionals were made when required, helping to support positive outcomes for people. An external professional told us, “They [staff] are so good and manage things really well.”

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

People’s rights to make decisions about their care and treatment were respected. Staff demonstrated a good understanding of the principles of consent and supported people to make day-to-day choices about their care, routines and preferences. Care records included information about people's capacity to make specific decisions, and where required, appropriate assessments and best-interest processes had been completed. Comments from staff included, “I believe consent is the first thing to do as a carer for people” and “I cannot do anything without consent, it is really important. It’s their will, not me doing it to them. I need to ask them first.”

Observations during the assessment showed staff sought people's consent before providing support and encouraged people to remain as independent as possible, promoting choice, control and dignity.