Priority Care Home

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• 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 did not always make 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 well assessed including at preadmission and were continually reviewed by senior members of staff. However, there were at times missing or contradictory information including people’s mobility and fluid intake. The service immediately put actions into place to improve this, including updating care plans and speaking with staff.

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. They worked to develop evidence-based good practice and standards.

The service supported people to receive evidence-based care, for example, by working closely with GP colleagues who visited the service on a weekly basis. The service also worked closely with nutrition teams (STEW) to provide positive outcomes for people at nutritional risk. Professionals agreed the service improved outcomes through evidence-based care. One professional told us, “The carers are quick and efficient to contact the GP team appropriately when they have concerns regarding their residents and follow policy to contact telemed [telephone health services] and other third-party agencies appropriately.” People’s care plans were evidence based and rooted in relevant legislation, for example, MCA (2005). Where people’s capacity was considered throughout care planning and involved discussions with people about what was important to them. This included care plans which focused specifically on people’s interests in an “above and beyond” care plan.

The provider worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

There was a good level of teamwork within the service, with people, staff and external agencies. Staff provided a high level of positive feedback regarding the service’s ability to work well together. One staff member told us, “Communication between management and staff is really good.” We received a high level of positive feedback from professionals we spoke with. One professional told us, “They [the provider] demonstrate confidence in advocating for residents and involving the appropriate professionals.”

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

The service was excellent in supporting people to live healthier lives through close work with nutritional teams to ensure a safe and appropriate diet to reduce weight loss and improve outcomes for people. One professional told us, “Staff are proactive in identifying residents at risk of malnutrition and putting appropriate nutritional care plans in place, rather than waiting for concerns to escalate. Staff are receptive to advice and demonstrate that they are able to put recommendations into practice; since commencing nutritional (STEW) training the home have increased provision for residents with malnutrition following our STEW Standards.” The service was also proactive in managing health risks by having appropriate equipment in the home, for example, anti-choking equipment. People were supported to access relevant health services, including eye tests, oral care and counselling. People were also provided opportunity to join in various in house and community activities including day centres, trips out and a reading corner. Staff agree there are a high level of engaging activities for people. One staff member told us, “Residents are happy and they are engaged - the residents like to get involved. Staff get involved with the activities. There is positive feedback from families. Managers will help make ideas work.” People and their relatives agreed they were supported to live their best lives. One relative told us, I didn’t think [my relative] could manage to feed themselves, but the staff gently encouraged them and now they don’t need any help at all.”

The provider routinely monitors people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People’s outcomes were consistently monitored to improve outcomes, through regular care plan reviews completed by senior staff. However, there were a few occasions where people were documented to give the incorrect modified diet as stated in their care plan. The service immediately put actions into place to improve this, including updating care plans and speaking with staff to prevent future reoccurrence.

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

Processes were in place to assess people’s mental capacity. The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take decisions, any made on their behalf must be in their best interests and be as least restrictive as possible.

There was appropriate consent documentation in place which considered people’s capacity. Consent documentation was embedded with MCA 2005 principles, such as decision specific consent documentation.