Harwood 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 75 (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 had care plans that covered aspects of care including health and well-being to meet people’s individual needs. Professionals were positive about the service and their support to people. People and their families were involved in the reviews and assessment of their needs, and support was provided where needed to maximise their involvement. People’s individual needs had been appropriately assessed and were understood by the staff. People told us they were happy with staff’s support. Relatives said, “Yes, there are quite often meetings, and they will ask us to pop in to speak to them and discuss what [the person] needs or follow up on a previous discussions made” and “Yes, they will often ask my opinion or [the person] about care”.Staff had access to people’s care plans and risk assessments. They were aware of the different needs of people and related risks. Staff said any changes in people were reported to the manager and they discussed how best to support the person.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. Relatives were kept up to date with people’s care and support and informed about any changes. People, and their relatives as appropriate, had been included in discussions and reviews around their care and how this was to be delivered. The manager worked and sought support from different stakeholders to ensure the care was in line with legislation and current evidence-based good practice and standards. The manager and the staff team were motivated to plan and deliver people’s care and treatment, including what was important and mattered to them. This also reflected in the whole team approach to the care provision that has a positive effect on the service. One professional added, “The home manager very much came across as committed to learning, partnership working, and continuous improvement to ensure positive outcomes for people using the service.” The manager and the staff team communicated with people, their relatives and partners about their care and treatment that supported good practice, relevant to people’s care.

People’s nutrition and hydration needs were met in line with current guidance. Although a few relatives noted the mealtimes were at set times. However, people and relatives were mostly positive about mealtimes and choices. People said, “I ask for things off the menu and they’ll do anything” and “I get 2 choices of dishes, and snacks and drinks between meals”. A relative added, “There is always a choice and they will always make something if [the person] asks for it”, “Yes [the person] does [get a choice], [the person] is not eating very much at the moment, but [the person] did opt to have supper at 6pm instead of 5pm and they were happy with that” and “Yes they do [have choice], they can choose, even outside of what is bring, offered at meal time, it’s very good”.

Kitchen staff communicated with the staff team on a regular basis to ensure they had the right information on what people’s diets; preferences and any specific requirements were. People could have a drink or snack at any time. We observed people always had drinks available to them and were encouraged to have those. People received support where needed with meals and drinks to maintain a balanced diet. During mealtimes, we observed people were not rushed and were encouraged to maintain their independence with having meals.

The provider worked well across teams and services to support people. They made sure relevant records were available about people and their health and social needs if they had to transfer to other services, temporarily or permanently. The manager and staff worked and communicated regularly with people and their families to share any information or changes between them. For example, one person became really unwell during our visit and paramedics were called to attend the person. They were taken to hospital for further assessment and treatment with suspected infection. The relatives had been informed. People received care and support from the staff who knew them and their needs well. This meant they received person-centred care that was meaningful to them. Where needed, manager or senior staff would contact relevant professionals to work together and look after the people.

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 were supported to remain as healthy as possible. Relatives agreed they were informed of any changes in people’s health or wellbeing. They said, “I visit often so I keep close tabs on everything…I have that discussion with staff and we share things and what we notice any change with [the person]; we have a good working relationship”, “Yes, [the person has medical needs] and they have to deal with looking after that and if its uncomfortable at night they do help [the person]” and “Yes, if [the person] needs to see a doctor, they will call one in.” People were referred to various health professionals to address any health issues or changing needs in a timely manner. The staff team worked together to continuously monitor and oversee people’s needs and preferences. People were involved as much as possible in reviewing their health and wellbeing needs where appropriate and necessary. Staff worked together to help people look after their health and respond to any concerns or deterioration related to their health. The service liaised with different external professionals such as the mental health team, physiotherapist, occupational therapist and GP surgeries. People's changing needs were monitored appropriately to ensure their health needs were responded to promptly. The manager and the staff were knowledgeable and informed about people’s health and wellbeing The care and support for people's health and wellbeing was proactive and organised well.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The staff team routinely monitored people’s care and treatment to continuously improve it. They worked together to ensure that outcomes were positive and consistent. People had care and support that was co-ordinated, and everyone worked well together. One person said, “[Staff] are pleasant. [the clinical lead] comes and sees me. I have seen the GP.” Staff supported people so they were enabled to live as they wanted to, seeing them as individuals with skills, strengths and goals. Staff were patient and used appropriate styles of interaction with people and their families. The manager and the staff worked together to use effective approaches to monitor people’s care and treatment and their outcomes. People were valued by the whole staff team who showed genuine interest in their well-being and quality of life. Relatives agreed the managers and staff were knowledgeable and provided specific care to people as appropriate. Relatives added, “Yes I think so because I go in every week and I always look in the office and speak to someone before I see [the person] – They are very good” and “[Staff] do an amazing job under difficult circumstances – [the person] has specialist needs and they have taken on board training to support [the person] better and I regard that as progress”. We observed staff were calm, respectful and attentive to people’s emotions and support needs, such as sensory sensitivities.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People's rights to make their own decisions, where possible, were protected and respected. Staff sought people's consent before providing care or support. We observed staff were polite, kind and respectful towards people and respected their decisions. If people did not want to do something or take part in an activity, the staff responded appropriately. One person noted to us the staff did not always ask for consent first, but others agreed staff were polite to them. Relatives were complimentary about staff’s support and the way they treated people. They said, “Yes they do [respect person’s decisions]…they have a good relationship”, “I think they do very well…I think they ask [the person] all the right things” and “Yes, for instance they try to encourage [the person] to mix with other residents and if [the person] says no, they don’t force [the person], but might suggest something else”.