Silver Howe

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 care, treatment and support achieved good outcomes.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Some people told us they had been involved in their care planning. We were told care plans were reviewed involving the relevant people. People’s differing communications needs had been appropriately recorded. A variety of clinical assessments tools were used to assess and manage people’s needs.

The provider did not always plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

Where people had different dietary needs, these were appropriately recorded. We saw people were supported with eating and drinking where they needed. However, we observed during lunchtime some people would benefit from using adapted crockery or cutlery. Feedback from people about the food choices and the quality of food were positive. Records for fluid intakes did not always show people had received the recommended daily allowances. However, we did see people were offered and supported with drinking regular fluids. Records for repositioning people requiring 2 hourly changes did not reflect this was happening. However, we saw people had their positions changed but not as recorded.

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.

Care records were electronic and these were accessible to staff in live time. We observed regular handover of information at each shift change. Meetings were held regularly for sharing information and referrals to specialist teams were made. Weekly clinical reviews of care were held with the GP and or practice staff.

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 were supported in making choices about their own health needs where they could. People were supported to access a variety of external health professionals such as the dentist, optician and podiatrist as and when they needed to.

The provider routinely monitored people’s care and treatment to continuously improve it. However, records did not always reflect clinical expectations and the expectations of people themselves.

Reviews were completed where people’s needs were reassessed. Records used for reviews were not always current or reflective of where professional advice had been given for example where district nurse advice for management of pressure ulcers had been provided. Records for monitoring fluid intake showed people were not receiving the recommended daily amounts. Records used for monitoring repositioning showed that frequency was not completed in line with professionals’ recommendations.

The provider did not always record accurately information relating to people rights around consent. The electronic care records were not regularly used to assess and identify people’s capacity and consents.

Where people had been resident prior to the change from paper to electronic records this had been recorded. The manager’s monthly oversight spreadsheet identified families who held power of attorney POA and could consent. We observed staff being courteous and respectful when asking people for consent to do things.