Freshfields Residential 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 requires improvement. At this assessment, the rating has changed to 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’s needs were assessed before they began using the service. The assessment covered all key aspects of their care and support, including mobility, nutrition, personal hygiene, medicines, communication, and social interests.

The management team gathered as much information as possible from people, their relatives, and the local authorities commissioning the care packages. This ensured they had sufficient detail to understand and meet each person’s needs.

Using the information collected during the assessment, the registered manager developed a personalised care plan for staff to follow, involving the person and their relatives throughout the 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 good practice and standards.

The provider made sure that people received care and support in line with current best practice and relevant guidance.

Staff were trained and had the skills and knowledge needed to support people who used the service. They followed the latest guidance in place when supporting people with their needs, for example, using the latest aids available when supporting people who had limited mobility.

People were very complimentary on how staff supported them. They did not raise any concerns to us. A person told us, “The staff are very kind and very caring.” A relative said, “The staff are fabulous, they treat my [family member] as their own.”

The provider worked well across teams and services to support people.

The management team worked in partnership with other healthcare professionals to ensure people’s needs were met fully. For example, the local GP visited the service weekly to review people’s health needs and as required if a person was not well.

People's health needs were monitored and reviewed as required to ensure staff continued to meet their changing needs. People were supported to access routine medical support from healthcare professionals such as GPs, to ensure their health and wellbeing was maintained.

Staff had access to people’s care plans, on electronic handheld devices. Any changes in people’s care needs were updated as soon as possible. This helped to ensure staff had the latest information about what the people’s needs were and how to meet them.

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.

The management team had an effective working relationship with a number of health care professionals to ensure that people received co-ordinated care and support. Information about the involvement of healthcare professionals in people’s care was available in people’s care records. This meant staff had the information of who to contact for advice or in the case of a person was not well.

Staff monitored people’s health care needs and informed the registered manager of any changes. For example, on the second day of our visit, staff had contacted the GP as a few people were not feeling well and had a chest infection.

Relatives told us they were always informed of any changes in their family member’s care needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

The provider continually monitored people’s care needs to ensure they were being met. We noted people had an allocated member of staff (keyworker) who coordinated all aspects of care of the person and monitored the person’s condition and report any changes to a member of the management team.

Care plans were kept under review to ensure staff continued to meet people's changing needs.

This was done with the involvement of people who used the service and their relatives.

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

At our last inspection, we found Mental Capacity Assessments were not always completed. Care plans, where people were diagnosed with having dementia, did not contain mental capacity assessments. This meant it was unclear whether the service was always meeting their needs or acting in their best interests.

During this assessment, we found people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Where people did not have the capacity to consent, the staff acted in accordance with legal requirements. Mental capacity assessments were in place.

The registered manager and staff had a good understanding of the principles of MCA. People were able to make day to day decisions about their lives. For example, they were supported to choose what they would like to eat or how to spend their time as they wished.

Staff understood the actions they needed to take if they felt a person lacked the capacity to make specific decisions about their care and support. They recognised that a person’s capacity could fluctuate and provided support accordingly.

Staff also ensured they obtained consent before carrying out any tasks, such as assisting people with their personal care.

The registered manager was aware of the process to apply for DoLS to the local authority when they believed people were being deprived of their liberty for their own safety.