Cornelius 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 79 (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 thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The registered manager completed initial assessments of people’s support needs in person before people decided to move into the service. Guidance for staff to follow around people’s care stayed current as regular reviews were taking place which actively involved people in discussions about changes to their care. A person said, “Someone sits with me and we talk about how things are going and if we need to make any changes to the routine.” Where appropriate people’s relatives were involved in their loved one’s care including when changes were made. A relative said, “We have regular conversations about [loved one’s name] support, they ask me for my opinion, and we go through the details together. I’m always pleased to know they have discussed this with Mum first.”

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 provider used information about people’s support needs and health conditions and involved people and their relatives where appropriate to inform guidance they created for staff to follow. They updated people’s documents and support when health professional input had been given. People told us staff knew their preferences and what mattered to them and received support which consistently matched this. One person said, “They all know my routine, it’s very important to me.” Tools including the Malnutrition Universal Screening Tool(MUST) were being used to identify if people were malnourished or at risk of undernourishment and obesity alongside the Waterlow assessment to identify people’s risk of developing pressure ulcers. The provider’s system not only recorded these details but gave the registered manager insights into trends which were being tracked to identify if changes to support delivery were effective.

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.

When people needed to access other services including hospitals, information about their care, preferences and how they communicate was shared in care plans, promoting smoother experiences. Where needed staff had accompanied people to health appointments including when they attended hospital helping facilitate positive outcomes.Health professionals had complimented the care people receive from the staff team. comments included, “staff really do know the residents” and “We had never known a care home like Cornelius House, because their staff come to see residents while they are in hospital.” People were being supported by routine weekly GP visits within the service and told us this provided consistence around their health care. One person said, “The doctor visits us most weeks, if I need something looking at, I tell the staff and they put me on the list. It’s reassuring to know they come so often.” Staff described the working relationship between services as positive. One staff member said, “The doctor is great we can ask questions about people’s conditions and how to support them in the best way and the doctor gives us really helpful information.” A person with a specific health condition had been supported to effectively receive treatment from the tissue viability nurse. This resulted in an improvement in their health condition which had positively affected their overall wellbeing.

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’s support was built around their individual needs, wants and preferences, carefully balancing this by providing people information about their health conditions helping them to make informed choices. For example, staff gave people advice about sugar content in meals and offered healthy alternatives supporting a person to manage their diabetes. Systems were in place to track people’s nutrition and fluid intake which alerted staff if actions such as offering drinks were missed. We observed staff responding to a heatwave by offering extra drinks and ice lollies helping people maintain their health and risk of dehydration. Staff said, “It’s really important to stay on top of hydration especially in the summer, some people don’t like to drink a lot but if you offer them something else like a frozen lolly they may accept it.” We observed people having their lunch who described the food as, “Very tasty” and, “The chef knows his stuff and how I like my food.” Where people required specific diets, a process was in place which communicated their needs to kitchen staff.

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.

The provider used a digital system to monitor people’s wellbeing. This was added to people’s care profiles and adjusted when these changed; these included blood pressure, skin integrity, people’s emotional status and weight among others. The system showed patterns and trends and provided staff with information informing them if people’s outcomes and goals were being achieved and provided opportunities for intervention if needed. Staff effectively monitored people's health using the electronic recording system. For example, when the system showed a person had gained weight, staff recognised the potential risk to their health and wellbeing. Working in partnership with the person, staff promptly requested a dietician review. Staff then updated the person’s care plan to incorporate the specialist guidance. As a result of staff following this updated plan, the person safely returned to their target weight and was supported to maintain it. When data indicated a person was refusing personal care, creating risks to their health, staff used the electronic system to create action plans and analyse patterns. This helped identify the underlying reasons for the person’s decline in engagement. Working responsively, staff implemented changes to their approach. As a result, the person's engagement with personal care and social interaction significantly improved, reducing health risks and enhancing their overall wellbeing. People were supported to access other professionals including dentists, opticians and GPs alongside others for regular reviews when needed, helping catch changes in health and promote positive outcomes.

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

People consistently told us staff always sought their consent when offering support. A person said, “They know I’m happy with how they help me, but they still talk me through everything and explain what they are doing. It’s those little touches that make the difference.”

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and had received training. One staff member said, “I ask people if I can give support and wait for them to acknowledge, sometimes they do this verbally or the response can be facial expressions or other body language, it all depends on their strengths. If a person doesn't want to receive support at the time I offer, I give them space and come back.” Risk management processes adhered to the Mental Capacity Act 2005 (MCA). The registered manager ensured staff completed formal capacity assessments whenever a person’s decision-making was in doubt. Relatives and legal representatives were consistently involved in best-interest decisions, resulting in collaborative care that successfully balanced safety with individual rights.

The registered manager had embedded an understanding in the staff team around people’s right to refuse. When people chose to refuse, the staff team looked for the reasons working with the person to resolve them. For example, when a person was declining personal care, the staff looked for ways to involve them in the process utilising their strengths and preferred communication method resulting in the person accepting personal care. A staff member said, “It’s all about the why, there’s normally a reason people refuse things.”