Elstow Manor

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 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. Although there were areas in people’s care plans that would benefit from further review or expanding on the information documented, the provider was aware of this and was already working through action plans to improve this. Overall, we found people’s care plans and the assessment of their needs provided enough information about how to care for and support people. Staff we spoke with had a good understanding of people’s care and support needs. A relative told us, “They have review meetings fairly often; where they will discuss the care plan and any changes and we have input in what goes in the care plan.”

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. Clinical tools, such as the Waterlow assessment, were used to assess the risk of skin tissue breakdown and the Malnutrition Universal Screening Tools were completed to identify and take action in response to people’s health risks. There were systems in place to ensure that people’s nutrition and hydration needs were included in their care plans and communicated to all staff, including where modifications to their food and fluid texture were required following input from speech and language therapists.
The provider had created themed areas based on best practice research to enhance engagement and comfort. These spaces featured a clothes folding area, which allowed people to experience a sense of purpose and accomplishment. Additionally, there was a nursery area and lifelike robotic pets designed to evoke nostalgia, provide comfort through familiar items, and promote relaxation and pleasure. A relative said, “Since the dementia community opened on the first floor it’s much better.”

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.
Records showed, and staff informed us, people had been supported in accessing external health professionals, such as when they needed to attend hospital appointments. People had access to visiting health professionals within the home, such as opticians, dentists, hearing check-ups, podiatry and chiropody. We observed where people’s needs changed, the service sought timely support from external health professionals.
The registered manager informed us the service had made significant efforts to enhance its relationships with local GPs and community nurses. We reviewed the compliments held by the service from these professionals, which confirmed relationships had greatly improved and were no longer a concern since our last inspection. A relative told us, “It is much better than it was a year ago; back then it was difficult getting medication prescribed for [Relative], but that has become much quicker and much better, and I think the home has sorted that out.”

The provider always 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 in accessing exercise-based activities, such as chair exercises and yoga. For example, we observed a disco-themed exercise session where people were supported to move their arms and legs to disco music. Therapeutic activities, such as Reiki, massage, aromatherapy, and pet therapy, were available every week.

The service had implemented 'snack stations' in strategically chosen locations throughout the service to encourage people to help themselves with snacks throughout the day. This initiative promoted choice and independence, allowing people to make their own decisions about when and what they eat. The availability of snacks also contributed positively to their nutritional intake, thereby improving overall health and well-being. The service had also increased their drinks and snack trolley rounds.

Where people needed their food to be modified; this was prepared to be presentable and fortified. We sampled some pureed foods during our visit and found them to look, smell and taste of excellent quality. A person said, “It’s tasty and well cooked, variety is good, there are options and choices, like in a restaurant.”
 

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. A person told us, “The level of care is exactly what I need at this stage, I think it’s the best possible care I can imagine. I say that because care and clinical staff are knowledgeable about what we need, and they keep an eye on any changes.”

A daily meeting was held and documented, attended by leaders and department heads. This included reviewing if there had been any adverse incidents, people’s health, upcoming appointments and celebrations. Records related to people’s bowel movements, fluid intake, wounds and repositioning records were also reviewed daily by leaders and senior staff to ensure people’s health-related care needs were met. This meant leaders could effectively oversee the day-to-day running of the service and could proactively hand over and act on the information they received. These systems meant that people, their relatives and external professionals were kept informed without delay.

The service had completed ‘case studies’ which demonstrated how they had been proactive at supporting people with positive outcomes. An example of this was a case study on how the service responded and supported a person who had acquired a pressure related injury. The case study covered aspects such as regular repositioning and their diet which contributed to healing. A staff member told us, “It’s exhausting, no doubt, but I get home and have the satisfaction that I’ve helped someone have a good day.”
 

Where the service determined people could not consent or make specific decisions, such as receiving help with their hygiene, this had not always been done in line with the Mental Capacity Act 2005 code of practice to include enough detail about how their capacity had been assessed . We did not find this had impacted people. The provider was already aware of this from a recent local authority assessment and was working on action plans to address this. However, staff understood what consent meant, and we observed staff seeking consent before delivering care to people.