Bilton 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.

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.

Assessments were completed for people prior to them moving into the home. Where possible, the registered manager invited them to the home to have lunch. This ensured they accurately evaluated how well the home could meet their needs in the environment. It also gave the person an opportunity to experience the setting, meet staff, and build familiarity before they decided to move in. The registered manager reviewed the assessment to ensure the home was fully able to meet the person’s needs before agreeing to their admission.

People’s needs were reviewed routinely or as required, and people told us they were involved in this process. However, relatives reported they were not always included in reviews of their loved one’s care plans.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Some people had their food pureed, to make it easier for them to chew and as an added safety measure. However, this was not always implemented with proper guidance in place. Care records also required more detailed information on people’s eating and drinking requirements as staff were often unsure as to why certain measures had been put in place. Following our concerns, all necessary referrals had been made to the speech and language team and appropriate guidance recorded.

Staff used nationally recognised tools appropriately to assess and monitor people’s needs. For example, the Malnutrition Universal Screening Tool (MUST) was used to identify people from risk of malnutrition, as well as the Waterlow Score, a clinical tool used to assess a person’s risk of developing pressure ulcers.

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.

Staff took part in handovers at every shift change. A handover book detailed important information needed for the next shift.

External health care professionals told us staff communicated well with them. A district nurse told us how staff were “curious” and eager to learn from the nursing team so they can better support people. They told us, “They will always ask questions.”

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 were supported to access healthcare when they needed it. One person told us, “I can see the GP, nurses, chiropodist if I need, and the optician.”

People were encouraged to take part in activities that promoted their health and well-being, such as outings in the community and activities within the home, for example armchair exercises. At the time of the inspection, a staff member was in the process of arranging training in leading armchair exercises to better support people to take part in this activity.

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.

Processes were in place to monitor the care and support people received. Records showed people’s weight was routinely monitored as well as their skin integrity and concerns escalated where necessary.

One person who was diabetic had their blood sugar monitored regularly. Their care records contained detailed instructions on what to do if staff had any concerns.

Healthcare professionals also reported good outcomes with one professional describing how their advice to increase a person’s protein had been followed by staff and resulted in improvements to the person’s pressure ulcer.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The registered manager showed a commitment to promoting people’s right to make their own decisions. However, they lacked knowledge around the Mental Capacity Act and their responsibilities to assess capacity where required. The registered manager recognised this was an area for development and further training had already been scheduled for staff. Furthermore, in-depth training was planned for the manager.

People shared no concerns about their right to make decisions being restricted and were able to make choices about their daily routine. Relatives told us staff gained consent before delivering care. One relative told us, "I've definitely seen staff seek consent. They are pretty good."

Care plans gave detailed information on how to support people should they decline care, such as coming back and trying again when they are ready. Other important information such as details around people’s lasting power of attorney were documented.