Prinsted Care Home

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 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 71 (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 and reviewed in a holistic way and their views, and those of their relatives, were included. A relative said, “They listen to what I say about his care, and it is always taken seriously and respected.” Assessments were clear, detailed and considered people’s individual needs. Some people had multiple health needs, their risk assessments and care plans were comprehensive. For example, a wound care plan included advice from a Tissue Viability Nurse (TVN) and strategies to support healing, including anticipatory medicine, which had been administered in line with the prescriber’s advice. A diabetes care plan included details about blood sugar levels, including what was normal for the person and what to do if readings were outside the normal range. A person was receiving fluids through Percutaneous Endoscopic Gastrostomy (PEG) tube directly into the stomach. There was a clear risk assessment and care plan to guide staff in how to care for the PEG site and who to contact if support is required.

Care plans were personalised and included details about how people were affected by their condition. For example, one person who had dementia sometimes became disorientated and confused at nighttime. The care plan identified strategies to support them, including regular checks to reassure them, leaving a night light on and the bedroom door open.

People’s communication needs were assessed and reviewed. One person had advanced dementia which compromised verbal communication. Their care plan included strategies for staff including reducing distractions that might hinder communication.

The provider did not always plan and deliver people’s care and treatment in line with legislation and current evidence based good practice and standards.

People’s nutritional and hydration needs were not always met. Some people were assessed to be at risk of choking and there was inconsistent practice with regard to modified diets. We have commented further about these risks within the quality statement for Involving people to manage risks. People were not always receiving the support they needed at mealtimes and people’s mealtime experience was variable. We observed staff were not all following good practice when supporting people. One staff member was supporting a person to eat, they were very task focussed and did not interact with the person to tell them what was on their plate or to ask what they would like to eat, this continued throughout the meal. Another person was not receiving support from staff, we observed they had difficulty holding cutlery and managed only a couple of mouthfuls of their meal. Staff were not checking how they were managing and did not notice the bowl had ended up in the person’s lap. This was not in line with the person’s care plan. Another person sat for more than 30 mins while staff supported other people, before they were offered their meal. A staff member offered them a choice of food and proceeded to support them with their meal, but without further engagement because they were talking to other people in the room. These experiences did not support a dignified and pleasant mealtime experience. Some staff were providing a more person-centred experience, we noted how a staff member was engaging with the person they were supporting, checking what they wanted to eat and supporting them at their pace. In other areas of the service people were enjoying a companionable meal with tables that were nicely set and staff who were attentive. People said they enjoyed their meal and were offered choices. One person said, “The food is very good.” We asked the registered manager to review the deployment of staff at mealtime, to ensure people were receiving consistent support in line with their care plans.

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.

People and their relatives told us they were satisfied information was shared appropriately between staff and services. One person told us, “They (staff) all know my needs.” A relative said, “Communication is really good.” Staff described effective systems for supporting information sharing including with each other and with health and care professionals. For example, one staff member said, “We liaise with the GP surgery every week and email updates, it's an effective system.” A health care professional said they were confident information they provided was utilised effectively. They said, “Staff know the residents well and seem motivated to follow (professional) advice.”

Staff described positive teamwork and effective systems to share information. One staff member said, “There’s a good bond here and everyone helps each other.” Another staff member said, “We work well as a team and provide good quality care.” We noted systems for sharing information included handover meetings and communication records. A communication book included appointments that needed to be arranged or were due to happen and details that needed to be followed up. Staff said this supported them to keep abreast of any changes and planned appointments.

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.

People and their relatives told us staff were proactive in supporting their health needs. One person told us staff supported them to make routine appointments with the dentist and optician. Another person said, “Everything is organised for us here, doctors etc.” A relative described how staff contacted relevant health professionals when required. They said, “They are in good hands here.” A health care professional spoke highly of the staff including the clinical staff. They described working regularly with staff to support assessments of physical needs and mobility. They said equipment was sourced to ensure people’s mobility was maintained whenever possible.

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.

People and their relatives told us they had confidence in the skills and knowledge of the staff.

One relative told us, “They (staff) can cope with all his medical needs.” They described how staff were knowledgeable about their family member’s medical condition and said, “They do everything pretty well.”

The provider’s systems supported monitoring of people’s health needs. For example, records included a clear risk assessment and care plan for a person with diabetes. This included regular checks with the diabetes nurse and an annual check with the diabetic eye clinic.

One person needed to receive fluids through a PEG feed. We spoke with the nurse who was knowledgeable about the procedure and care of the PEG feed. Systems were effective for monitoring fluids, and the nurse checked this every day to ensure the person was receiving adequate fluids through the PEG feed. Staff monitored people’s skin integrity. One person had a wound related to diabetes and a wound care plan was in place with appropriate pressure relieving equipment. Staff were monitoring the wound and had made a referral to the Tissue Viability Nurse (TVN) for support when they noticed it had worsened. Staff regularly monitored people’s weight and alerted the GP if there were concerns about unplanned weight loss.

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

People and their relatives told us staff understood their responsibilities for seeking consent before providing care and treatment. One person told us, “They (staff) always ask me.” Staff we spoke with were clear about how they needed to seek consent. They told us, “We have to assume people have the mental capacity to make a choice, we always ask and offer a choice.” Another staff member said, “People have the freedom to make an unwise decision, however if they lack capacity we would need to be sure a decision was in their best interest.”

Records showed issues of consent were considered in line with the Mental Capacity Act 2015. For example, some people had restrictions in place to reduce risks, including the use of bed rails to prevent a fall from bed. Where people lacked capacity to consent to these restrictions, the provider had recorded how decisions had been made in people’s best interest with the involvement of relatives and professionals where appropriate. Some people were subject to Deprivation of Liberty Safeguards (DoLS) and appropriate applications had been made to the local authority.