Nichols 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.
This is the first assessment for this service. This key question has been rated Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.
 

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed, and care plans contained information about their health conditions, communication needs and preferences. Staff demonstrated a good understanding of people and how to meet their needs.

However, care planning was not always sufficiently detailed in relation to managing a person’s health risks and accurate in relation to their current mobility needs. This limited its effectiveness as a tool for delivering care and ensuring people’s needs were assessed and met.

Overall, people were supported to receive care and treatment based on their assessed needs. Staff demonstrated an understanding of how to support a person with a complex health condition and monitored this appropriately. Records showed the person’s health condition was monitored, observed and recorded. Relatives told us staff were competent in responding to this health condition. One relative said, “They managed [name of health condition] properly, they’re obviously trained.”

We observed that not all required referrals to health professionals had been made at the time of our inspection. This meant systems were not always effective in ensuring people received timely input from relevant professionals. In response, the provider took or planned actions to address this.

However, the provider had worked with other professionals to support people, and staff communicated with families regularly. Relatives confirmed this. One relative said, “We have learned to trust them now and we can contact them if we have a niggle.”
 

People were supported to live healthy and active lives. Staff supported people to access regular exercise, maintain a varied diet, and take part in activities in the community. One relative said, “[My relative] loves going for walks and goes swimming weekly and to the cinema… they do a lot.”

The provider did not always effectively monitor and improve outcomes for people. Issues identified during the inspection, including those relating to medicines, environment and restrictive practices, had not been identified through audits. This meant there was a risk that improvements were not always identified and made in a timely way.
Although the provider had identified some of these concerns and developed a service improvement plan to address them; this work was not complete at the time of the inspection.
 

The provider did not always ensure care was delivered in line with the Mental Capacity Act 2005. In relation to one person, we identified restrictive practices that were not clearly supported by mental capacity assessments, best-interest decisions, or appropriate applications to lawfully deprive a person of their liberty.
We did not observe this had a direct impact on the person at the time of the inspection. The provider responded to our concerns by making the required applications. However, staff were observed seeking consent in day-to-day interactions, which demonstrated an understanding of the importance of involving people in decisions about their care.