New Milton 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 71 (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 needs had been holistically assessed and detailed care plans were compiled to guide staff to support them in a person-centred way. They covered all aspects of people’s lives and were reviewed monthly. Information such as weights, observations and outcomes of malnutrition universal screening tool (MUST) score, and a tool used to identify people at risk of developing pressure ulcers (Waterlow assessments) were updated during care plan reviews.

People and their relatives were able to contribute to their assessments and care plans should they want to and if people’s needs changed, there would be a review and update of care plans.

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 evidence-based tools to assess and plan to meet people’s health and wellbeing needs. For example, people were weighed each month and their malnutrition universal screening tool (MUST) scores calculated, which provided information indicating if weight loss was concerning. This was used when calculating other risks such as the risk of skin breakdown and whether people needed meals to be fortified or referred to healthcare professionals.
As mentioned in the medicine’s optimisation section, there were areas of good practice not in use, however the provider addressed these shortfalls before the end of our inspection.

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.

Hospital passports were available for people to take when admitted to hospital detailing care needs, health information and other useful information such as contacts for relatives and professionals.
The provider also worked with social care professionals and other providers to support people to access appropriate services. For example, a person had been assessed as suitable and admitted to New Milton House. Immediately after admission they presented very differently and had needs the service was not able to meet. The provider worked with the person, their relatives and professionals and managed to source a more suitable placement for them within 24 hours ensuring their new provider had a clear and accurate assessment of needs.

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.

The provider established effective systems and processes to ensure people’s day-to-day health and wellbeing needs were being met, and people experienced positive outcomes related to these needs.

The provider had positive relationships with health care professionals in their locality. People were regularly seen by medical staff such as members of the Care Homes Assessment Team (CHAT) and their GPs. Community nurses regularly attended the service and there were GP and CHAT rounds each week. A separate document was maintained in peoples records to be completed to inform what took place when healthcare professionals consulted with people. Records also contained letters and treatment plans from healthcare professionals.

The provider ran a selection of activities including 3 different exercise sessions each week. These included seated exercises, yoga and massage and tai chi. The sessions were popular and had been successful in supporting people in improving their mobility and in minimising the impact of symptoms of health conditions.

A relative told us, “My [person’s name] health has improved since they have been here. That is partly down to [healthcare professionals] and the way people at the [service] have supported them. There is a level of vigilance here that is noticeable.”

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.

Monitoring was completed regularly for a wide range of health and social needs. For example, seizure charts were completed for people living with epilepsy, regular weights were recorded, and food and fluid charts were completed as needed. Information collected was used to inform relevant professionals at healthcare appointments and to monitor the progress of healthcare conditions.

Most relatives were happy with how well the provider monitored their family members, a relative told us, “One of the carers noticed mum had a chipped tooth and then she developed an abscess. That was good that it was picked up.” However, we also had feedback about both oral hygiene and fingernail care that was not as positive. For example, a person had dirty and long nails that needed attention and 2 people were enabled to be independent in cleaning their teeth however had poor oral hygiene. The people concerned had capacity to refuse help however so staff could prompt them only, however returned to them to ask them again later. The provider organised dental appointments for people so risks associated with poor dental hygiene were managed.

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

We saw consent had been legally obtained from people covering permission for care, assessments, care planning, medicines administration, medicines ordering and access to personal information to outside agencies. When people were assessed as having capacity they signed a consent form. Authorised others such as their lasting power of attorney (LPA) signed consent forms on behalf of people deemed to lack capacity .Best interest decisions were made in the absence of a legally authorised person.

We found some consent forms were lacking signatures, and a person’s care record had no best interest decisions recorded. The provider addressed these concerns before the end of our inspection.