Care Home for Special Needs

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

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

People were involved in decisions about their care. They had access to information regarding care planning and were given choices about how to stay healthy and live as independently as possible.

We found staff were not making daily records about interactions with people.

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. Pre-assessments for people made sure the provider could meet their needs before service had begun. Feedback from people using the service was positive. Staff checked people’s health, care, and wellbeing needs during reviews and people told us changes were made when required.

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. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Care records we saw demonstrated care was provided in line with current guidance.

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. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. People at the service have been living there for a considerable time, so partner services were well informed of people’s needs and support mechanisms. The registered manager worked with 1 person’s [relative] closely to ensure they received night time support from their [relative] as this was a trigger for them if the [relative] was not available.

Staff cooked healthy meals based on people’s individual health needs and choices. The registered manager told us that they ensured people had tasty freshly prepared meals with adequate nutritional value so that people could stay healthy. People told us that they went out for walks and exercise with staff and that they felt well within themselves. Families told us that they were invited to join in for lunch or dinner to make the atmosphere ‘homely and comfortable’ for people. They also told us that they noticed that people maintained weight well. Records indicate that there had been no incidents of people suffering with hydration or nutritional deficiencies.

However, the lack of daily notes could pose a risk of dehydration or nutritional deficiencies, particularly for service users with communication needs. New or agency staff would not know if the person had eaten or drunk enough fluids due to a lack of recorded information. The registered manager told us that they would urgently ensure daily record keeping was implemented and audited.

The provider did not complete audits or analyse trends for improving outcomes. They told us that this was due to the small number of people at the home. They added that they knew people well and could see changes quickly and act upon any changes immediately.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People confirmed this, saying “I make own choices, staff always knock on the door and always ask me if I want something done like washing.” Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded in care plans.

Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation. Where people’s capacity to make certain decisions fluctuated, we saw assessments were specific to those questions. Best interest decisions were made with family and external professionals.