Sotwell Hill 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 did not consistently ensure that people’s care and treatment were effective, as care planning did not always accurately reflect people’s current needs.

Systems to review and update care planning were not always effective. Risk management processes required improvement. While actions were often taken in response to changes in people’s health, these were not always supported by clear or detailed risk assessments. For example, where people experienced weight loss, actions had been implemented in practice, however, there was limited guidance to support monitoring, identify risks or outline escalation procedures. Similarly, information relating to how specific health conditions affected individuals and how these should be managed was not always clearly recorded.

Risks associated with access to staircases had not been fully considered within risk assessments, which meant the provider did not have full oversight of potential hazards within the environment.

Where changes to people’s needs were identified, this information was shared with staff through handovers, and staff confirmed they had read and understood updates. The provider also responded promptly to people’s changing needs. This supported day to day communication within the team.

However, written care plans did not always mirror these changes, which meant records were not consistently aligned with current practice. Guidance was not always in place for staff to access around people’s mobility needs and equipment, or how to support people with their personal care. This could impact on the consistency of care delivery, particularly for new staff, or staff who were unfamiliar with people. Reducing assurance all staff would have access to reliable and up‑to‑date guidance to deliver care consistently.

People’s communication needs were well documented, and a range of assessment tools had been used to identify how best to support individuals. This supported staff to communicate effectively with people and meet their needs in practice.

The provider planned and delivered people’s care and treatment in partnership with them, taking account of what was important to them, following current legislation and evidence‑based guidance. However, improvements were required to ensure documentation consistently provided staff with clear and up‑to‑date guidance.

People received care which reflected their needs and preferences in practice. However, improvements were required to ensure care planning information was sufficiently detailed and consistent to guide staff and support safe, effective and person‑centred care delivery.

Some people required support with continence care. While care plans clearly outlined when support was required, daily records did not consistently evidence this support had been provided. The provider advised this was a documentation issue rather than care delivery, and no harm had occurred. However, the lack of recording reduced assurance care was consistently monitored.

Where people required specific food consistencies, these needs were not always clearly reflected within care planning documentation. Despite this, staff were supporting people appropriately in practice.

There was limited information available regarding the use of specialist equipment where the care plan indicated staff were to support the person with equipment, there was insufficient guidance outlining staff responsibilities or how to provide this support safely.

People spoke positively about the food provided within the service. Comments included, “I get my meals supplied, I’m looked after very well and I haven’t any complaints about the nursing staff,” and “One day I missed a meal, and I was offered soup and sandwiches later in the evening. There is tea and coffee all the time.”

We observed staff supporting people with eating and drinking in a respectful and discreet way, such as assisting to cut food where required. People told us, “The food is not like home cooked. I’m not a big eater but I get enough to eat. They will cut up things for me if I ask.”

The provider worked effectively across teams and services to support people.

There was good communication within the staff team, and staff worked collaboratively to meet people’s needs. Handover meetings were held at each shift change to ensure staff were kept up to date with people’s health, wellbeing and any changes to their care.

Information was shared appropriately between teams and external services to support continuity of care. Where people received support from a range of staff, teams or professionals, care was coordinated effectively to ensure people’s needs were met consistently.

The service worked closely with external healthcare professionals. People received regular visits from the GP and district nurses, which supported ongoing monitoring of their health needs and timely access to additional care where required.

The provider demonstrated a strong commitment to supporting people to achieve the best possible health and wellbeing outcomes. People were supported in personalised ways to maximise their independence, choice and control over their lives. Staff worked proactively with people to maintain their physical and emotional wellbeing, with a clear focus on enabling people to live healthier lives and, where possible, reduce the need for additional care and support.

People were actively involved in choosing and planning experiences important to them. People spoke very positively about the meaningful opportunities available to them to stay active and engaged.

People told us, “There are activities, games and trips out. I am supposed to be going to see the bluebells tomorrow if the weather is alright, I am looking forward to it,” and “I normally do the activities, the activity staff bring us a list of what’s going on and the carers take us along. I like doing them.”

Staff interactions reflected an individualised and strength-based approach. For example, when supporting a person to mobilise, staff engaged the person in conversation, monitored their safety and provided encouragement and positive reassurance. This approach promoted both physical wellbeing and emotional confidence.

Staff described how their approach had a significant and positive impact on people’s lives. For example, 1 person who had previously experienced high levels of distress and anxiety had been gradually supported to build confidence through tailored engagement with the activities team. Staff explained the person had initially been “stressed, worried and frightened,” but through sensitive, paced support they were now able to participate in and enjoy group activities. Demonstrating how staff adapted their approach to achieve meaningful and sustained improvements in people’s wellbeing.

The service also demonstrated a strong commitment to reducing social isolation. Where people chose to spend time in their rooms, staff ensured they remained engaged in ways which reflected their preferences. Records showed people were supported through meaningful interactions. Staff supported people who were more socially isolated to take part in group activities where appropriate, recognising the sensory and social benefits of inclusion, even when engagement varied.

The provider monitored people’s care and treatment to support continuous improvement and positive outcomes. Systems were in place to review people’s needs and ensure care remained effective and responsive to changes in their health and wellbeing.

People told us they were supported to maintain relationships and take part in activities which were important to them, including attending religious events and keeping in contact with family and others. Staff respected people’s privacy and supported them in ways which promoted dignity and choice.

Staff demonstrated a good understanding of people’s individual needs and were responsive to changes in their health and wellbeing. One person told us, “Sometimes I feel well, other times I don’t. I get tired quickly. People [staff] know when I’m not well and talk to me if I want them to.” This showed staff recognised changes in people’s wellbeing and adapted their support accordingly.

Information about people’s care needs was regularly shared through daily handovers, which helped ensure staff were aware of changes and could provide consistent support. These discussions were supported by the review of daily notes, which helped identify areas for follow‑up and ongoing monitoring.

The provider supported people to understand their rights around consent and respected these when delivering person- centred care and treatment.

People felt involved in decisions about their care. People’s views, wishes and choices were taken into account in how their care was delivered.

People told us staff were respectful and sought consent before providing support. Comments included, “They [staff] are so kind to me, and they knock on my door and ask me what I would like to do. They always make sure they ask me first before they help me,” and “They [staff] are very respectful and always ask me what I want before doing any sort of care.”

We observed staff practice which supported this. Staff knocked on people’s doors and waited to be invited in before entering. They asked people for consent before supporting them to attend meals or personal care, demonstrating a respectful and person‑centred approach.

Mental Capacity Assessments (MCAs) were in place for key areas such as medicines and personal care, the provider had systems in place to assess people’s ability to make decisions. However, there were some inconsistencies in records relating to Lasting Power of Attorney (LPA). The provider was aware of these gaps and was taking steps to address them.