Salford 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 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.

People’s pre-admission assessments considered people’s individual histories, who was important to them, their risks, equipment needs, next of kin contacts and their capacity to consent to elements of their care. We suggested to staff, to include a section, so people’s individual communication needs were established when they moved to the home. Staff told us people were able to visit the home and come for a cup of tea or a meal before committing to move in. These processes helped the person to make the right decisions for them.

Staff were alerted to new people moving to the home by the registered manager entering details on to staff’s “My notice” app (electronic application that holds people’s care information). Staff knew who the most recent admission was, their personal needs and who was important to them. A staff member said, “[Registered manager and deputy] tell us and they do a briefing about people's preferences and their relatives.” People’s pre-admission information was used to further develop their initial care plans. A staff member told us they received people’s initial care plans without delay. A staff member said, “We get the care plans straight away and update them when we find out more.” A visiting health care professional told us staff were very good at following guidance they had suggested which meant people continued to receive effective care and treatment. The health professional said when advice was given, staff always recorded their advice onto the providers systems.

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.

One relative told us their relative was happy, settled and they received the support they needed. They told us their relative was content in the home because, “It’s quiet and peaceful in this area just outside his room. It’s a nice little spot and people are passing through and he’s having a laugh with staff.”

People told us they enjoyed the food. One person said, “First thing in the morning the menu is suggested. It’s all very well organised. I choose something I’m going to eat rather than leaving food.” Where people needed specialist diets they received their meals in line with their preferences. Where people needed staff to help them, we saw this support was given in a way that did not rush the person.

A staff member said they used a recognised tool to determine a person’s food and fluid consistency so they could eat and drink in a safer way for them. Staff described 1 person who needed 1 scoop of thickener in their drinks. The person’s care plan confirmed 1 scoop of thickener in drinks as well as their modified diet. Staff said they took pictures of the meals prepared for people each day, so they can confirm the correct texture has been provided. We recommended staff also recorded the meal that was given. We saw one example where some information about a person’s food consistency was recorded slightly different on information held by the chef and the person’s care plan. Conversations with staff, showed they knew what consistency of people’s food and drinks. The registered manager took action to address this.

National recognised tools such as waterlow assessments (a risk assessment tool used by healthcare professionals to identify individuals at risk of developing pressure ulcers) and MUST (Malnutrition Universal Screening Tool) were used to assess and monitor people’s conditions. These tools were used by staff to ensure people received the support they required to manage their overall health and wellbeing. We checked people’s pressure relieving mattresses and, in most cases, they were set correctly. However, we saw 1 pressure relieving mattress that was flashing a red light for a service. This hadn’t been noticed by staff, however, the maintenance person when notified arranged for it to be fixed. There was no information to suggest this person had come to any harm.

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 followed the advice given by district nurses in relation to repositioning people, this would lead to improved skin integrity for the person. Staff at the home had been trained by 1 of the health and social care professionals to undertake specific elements of people’s care. For example, so staff could undertake people’s blood tests to check people’s platelet counts. One staff member said, “We have a good relationship with the GP” and said access to prescribers was swift when people needed extra or changes to their medicines. Staff were positive about handover arrangements, where all staff were included, and electronic care records were updated for staff to refer to. A visiting healthcare professional confirmed to us staff followed their advice and recorded the advice promptly on staff hand held devices.

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 wherepossible, reduce their future needs for care and support.

People were supported by staff to have prompt access to services to promote their health and wellbeing. These included GPs, prescribers, chiropodists, frailty nurse, district nurses, audiologists, opticians and social workers. One staff member explained how they supported a person with diet-controlled diabetes to maintain their health. A staff member told us, “If [person] had not been eating much, we would take a blood sugar reading and check their vital signs.” The staff member explained how and when they would escalate any concerns to other health professionals.

The provider routinely monitored people’s care and treatment to continuously improve it. Theyensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Relatives told us staff were confident and competent in monitoring people’s health to promote positive outcomes. One relative told us Salford House met their needs. They said, “[Relative] was at their own home, but it didn’t work, and he was definitely not safe at home. Here, it’s a home from home atmosphere and that’s why I wanted him here. It is right for him.” Another relative said, “They are good at getting help, tablets or the doctor to see you. They (medical services) appear to have all the info they need.” This relative told us how their relative had got equipment to manage their health condition which had made a positive difference.

Staff gave examples showing how they had escalated concerns for people’s health to other health and social care professionals. Staff handheld devices were used to prompt staff to provide specific areas of care to individual people. For example, catheter checks, fluid output, continence and repositioning to promote skin integrity. A ‘red flag’ on the electronic care system alerted the registered manager if any specific care tasks had been missed so they could act if any task was late of missed.

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

People told us they had full choice and control in their daily life at Salford House. For example, what time they got up, went to bed, what meals they ate and how they wanted to spend their time. One person told us, “The food is excellent. I have breakfast in my room – cereal, toast and sometimes I ask for oats. Most mornings it is around 8am then the care staff come to help me wash and dress.” This person told us that was their choice.

The registered manager considered people’s rights for choice and consent and people’s responses were respected. Where people had capacity, their capacity was assessed and staff respected people’s right to make decisions. One staff member told us how one person sometimes lacked understanding, but they still gave people choices, or they made a selection based on what they knew the person preferred. One staff member told us when they considered best interest decisions, “We go on the best of our knowledge of what [people] would want for themselves, for example, their previous preferences. [Leaders] will always ask us what we think. I say if [people] don’t like anything and it is taken into account if there is a best interest decision.”

Staff understood which other professionals needed to be involved when best interest decisions were taken. One staff member said, “We would get an advocate and the GP in if people didn't have family to input into best interest decisions.” The staff member told us “Staff would have a team meeting”, so staff views would be considered. A staff member shared an example with us of a GP recently having been contacted in these circumstances. We were also told by staff when support was given to a person’s lasting power of attorney by the registered manager. The registered manager helped the lasting power of attorney register a person's death. However, we found the documentation to support people’s choices and capacity varied. In some cases, there was limited evidence of the actions taken to ensure people had the best chance of understanding the decision to be made. The registered manager assured us more information would be recorded as part of the decision-making process. Our observations confirmed people’s consent was sought, before any support was provided.