Dorrington House (Wells)

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 previous inspection we rated this key question Requires Improvement. At this assessment the rating has changed to 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 needs, risks and choices were assessed and planned for. People and their representatives told us they were involved in their needs assessments and with compiling their care plans. A person’s representative said, “There are annual reviews and I am involved.”

People’s care plans contained clear and detailed information, with appropriate use of language, regarding their care needs and the levels of support they required. Care plans also contained information about people’s individual choices and preferences.Staff told us that everybody had a full review of their care and support on a regular basis.

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.

Staff assessed and planned for people’s nutrition and hydration needs, including dietary and cultural preferences. Some people were at risk of choking and had been assessed by a speech and language therapist (SALT). Staff followed the SALT advice and guidance to make sure people ate and drank safely. Some people were deemed as being underweight were supported to have fortified meals and drinks.

People and their representatives were mostly complimentary about the food and made comments such as, “The food is good, with choice at lunchtime. [Name] enjoys it.” People also told us that there was always plenty to drink, with comments such as “Yes, there is always water available.” And, “There's always a jug in the room and drinks come round regularly.”

Staff told us they had good knowledge and understanding in respect of people’s dietary requirements and told us, “I am aware of resident’s dietary requirements, allergies, preferences, cultural needs, and any modified diets. This information is clearly documented and communicated to staff.” They also said people benefitted from a positive mealtime experience. A member of staff told us, “Mealtimes are relaxed and person-centred. Residents are offered choice, encouraged to maintain independence where possible, and provided with support when needed.”

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.

There was a collaborative approach in supporting people’s care needs. Staff communicated effectively with other professionals. Referrals to external health and social care professionals were made promptly when needed and care records, as well as observations, confirmed that guidance and recommendations were followed.

All staff we spoke with were open and willing to engage. Staff were knowledgeable about the needs of people living in the home and respectful when discussing people’s care 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.People told us they were able to see doctors and other professionals when needed. They were happy with the support they had.People’s representatives told us the service was very good at recognising and addressing changes in people’s needs. A person’s representative told us, “I must mention [staff member]. [Staff member] has been key to [relative] becoming more settled and ensuring that [relative] sees the visiting nurse practitioner and GP when necessary.”

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.

Staff regularly monitored people’s wellbeing and support. When people were unwell, or there was a change in their conditions, management and staff increased monitoring to make sure they received medical support if needed.

Monitoring tools and records were kept for people’s food and fluid intake, medical conditions, weights and skin conditions. People had regular reviews, and we saw that action was taken quickly when any changes to health needs were identified.

People’s representatives made positive comments about the care reviews and improvements to their loved ones’ health and wellbeing such as, “I have found the care at Dorrington House excellent. My [relative] was at a real low, physically and mentally, after a lengthy period in hospital when [they] moved in. The Dorrington House team gradually built up [relative]’s strength and confidence. [Relative] is now doing well and I feel confident that [they are] very safe and being really well looked after.”

Staff told us they felt confident about supporting people with their individual care needs. A member of staff said, “I feel very confident in supporting residents with a wide range of needs and know when to seek specialist advice or guidance if circumstances change.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.The provider met the requirements of the Mental Capacity Act 2005 (MCA). People told us that staff involved them in all aspects of their daily care, asked for their consent and respected their choices. Staff were knowledgeable about the principles of the MCA and told us they always obtained people’s consent before doing anything for them.

When people lacked the mental capacity to make certain decisions, staff met with relevant and authorised people, to ensure any decisions made, were in the person’s best interests. People’s care records were clear about the decisions people had and did not have capacity to make or consent to.Mental capacity assessments were completed for people and, when needed, applications for deprivation of liberty safeguards (DoLS) were made appropriately. We saw that the least restrictive options were used with people and any DoLS conditions were met.A person’s representative also told us, “They consult me because I have power of attorney.”