St Matthews Limited - The Avenue

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 63 (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 always made sure people’s care and treatment plans were effective.

The provider completed pre-admission assessments prior to people moving into the service to ensure people’s needs could be met effectively. The provider was able to demonstrate pre-admission assessments were then used effectively to formulate care plans that we found were generally meeting people’s needs.

Although we found care plans contained adequate guidance for staff we also identified some areas for improvement. For example, where a care plan demonstrated people had a fluid restriction or required repositioning, the care plans did not specify the amount of the restriction or the frequency of repositioning. We also found care plans did not specify details of the setting required for pressure relieving mattresses.

Although we identified there was need to make some improvements to care plans we found there had been no impact on people. The provider had an electronic care planning system and showed us that specific interactions had been established to complete the tasks we identified required further detail in care plans. For example, there was an interaction guiding staff to support people to be repositioned at appropriate timeframes. The provider assurance us the improvement needed was more cross refencing care plans to interactions, and this work commenced during our assessment.

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 nationally recognised evidence-based good practice tools to assess people’s needs and support the development of care plans and risk mitigation plans. For example, the provider used the nationally recognised Malnutrition Universal Screening Tool (MUST) to identify if people were at risk nutritionally.

We viewed records relating to people’s weight during our assessment and found these were being taken in line with their identified MUST score. Where people were identified as being at risk of malnutrition or obesity, records showed people had been discussed with the GP or a referral made to the dietician.

We found the diets summary was not up to date at the beginning of the assessment. However, staff were knowledgeable about people who required fortified diets and this was quickly rectified by the registered manager.

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.

The provider had systems and processes in place to support communication between the staff team. For example, there was a clear handover process between colleagues, this meant that information was shared promptly and effectively. There was also a daily ‘flash’ meeting where all departments in the home would come together to share information, actions, and learning.
 

When people received care from different staff, teams or visiting professionals, it was co-ordinated effectively. A visiting professional told us, “The staff are always helpful and are able to share information about people we are here to see. They listen to the guidance we give them and act on this for the benefit of patients.”

The provider had introduced champions to support each other in specialist areas, and we saw evidence of champions for safeguarding, health and safety, falls, dignity, oral health and infection control to name a few. A staff member told us, “My colleagues are of real support to me. We help each other. We are a team."

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were supported to access healthcare services and staff worked collaboratively with external professionals to support people to attend medical appointments to manage their health and well-being.

We received mixed feedback in relation to the food offer at the service. On the first day of our assessment we observed the mealtime experience to be chaotic. We found the environment was uninviting and did not create a relaxed environment to be enjoying a meal. We also found that although there were meal choices available, staff were not utilising resources to give people maximum choice and control in relation to their meals. For example, show plates were not being utilised.

We received feedback from people, relatives and staff that yoghurts, fruit, milkshakes and biscuits selections were not readily available at the home. We also found the food that some people with a modified diet were eating was repetitive. For example, one person was eating Weetabix twice a day.

We shared our feedback with the provider and registered manager during our assessment and we observed positive improvements being made by the time our assessment concluded. For example, the introduction of show plates and availability of yoghurts, fruit, milkshakes and biscuits.

We were assured the provider had acted on our feedback and that the catering provision was being reviewed.

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.

We saw that people had long and short-term outcomes and these were planned as part of people’s care plans that focussed on clinical and non clinical care needs. The provider had identified how people would achieve their outcomes. Records showed outcomes were regularly reviewed.

Although our assessment found the provider was identifying and reviewing a range of clinical and non clinical outcomes, where appropriate, further development could focus on supporting people to develop goals and outcomes that focused on people’s social needs.

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

We saw Mental Capacity Assessments (MCA) and Best Interest (BI) meetings had been completed for individual decisions relating to people’s care and treatment. However, we identified some inconsistencies in relation to the decisions a MCA was being completed. For example, for one person we found there was no MCA for the use of bedrails or a hoist.

Staff had completed training in relation to the Mental Capacity Act and understood their responsibilities to seek consent.

Although we generally observed staff sought consent before carrying out interventions, we did observe occasions where staff were anticipating people’s needs and therefore did not seek consent. For example, a staff member was observed to wipe one person’s mouth with a tissue without any prior engagement with the individual. A relative also told us, “They don’t really ask his consent when giving [relative] tablets”