The Dale 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 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. Staff worked closely and positively with people, their relatives, and healthcare professionals to complete assessments of individuals’ needs. Due to the small number of people supported by the service, staff had a detailed understanding of each person’s needs, which was clearly reflected in their care records. Care reviews were undertaken promptly and at appropriate intervals to ensure that any changes in people’s circumstances or support needs were accurately recorded and incorporated into their care plans. A relative told us, “I am happy with the personalised care given to [relative] and I am kept informed of any changes whenever I visit.”

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. The service worked in partnership with GP's and other health and social care professionals to plan and deliver care for people in an effective manner. Risks to people’s health, safety, and well-being were assessed and monitored using recognised clinical tools, including those used to identify the risk of malnutrition and deteriorating skin integrity. Where risks had been identified, appropriate measures were implemented and monitored. Interventions such as fluid monitoring and regular repositioning were carried out consistently and in line with people’s assessed needs and care plans, helping to promote their health and reduce the risk of harm.

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 between different services. Healthcare professionals and partner organisations spoke positively about communication with the service and told us there were no barriers to effective partnership working. However, staff told us more regular team meetings would support communication, planning and the delivery of people’s care and support.

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. People told us they had regular visits from a GP and were provided with nutritious food, which they enjoyed. However, people and relatives told us they would like more opportunities for meaningful activities and stimulation. Comments included, “I would like to see more activities for [relative], a singer would be nice,” and “I enjoy the balloon activity, but it is once every 2 weeks.”

People did not always receive support that met their social and emotional needs. A small number of people were mainly supported with task-based care, with limited meaningful interaction from staff. Care records contained limited evidence of regular social engagement or checks on people's emotional wellbeing. However, the service had since implemented activity care plans for each person, to ensure their social and emotional needs were being met.

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. Staff recognised when a person was not drinking enough and took appropriate action, including escalating concerns to relevant healthcare professionals. Care records demonstrated that people’s health and wellbeing were routinely monitored and reviewed to help ensure their changing needs were responded to appropriately.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Care plans detailed people’s mental capacity in good detail, and best interest decisions were person-centred and decision specific. We observed staff seeking people’s consent before providing care and support. However, our findings identified that further knowledge and development were required in relation to application of Deprivation of Liberty Safeguards (DoLS) to ensure legal safeguards were consistently considered and applied for in a timely manner.