Ernest Bold Resource Centre

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 79 (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.

There was a process in place to ensure people’s needs were regularly assessed. The assessments we reviewed were detailed and considered people’s individual risks, needs and preferences. People were at the centre of these reviews and those important to them were also involved.

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 staff team ensured and implemented the right support, right care, and right culture guidance. Staff were well trained and confirmed they received good support and training to meet the needs of the people they supported. Staff were aware of and followed national guidance and recommended approaches to care provision.

Staff encouraged and promoted people to live independent and fulfilled lives. There was emphasis from the provider about developing a good quality of life for people and this was promoted by participation in activities and tasks within the service and the wider community.

There was also a system in place which used evidence-based tools to assess people’s needs. A variety of assessment tools were available if needed to ensure people’s needs were identified and met. Staff were aware of these outcomes to ensure they delivered the correct care that people needed.

The provider worked well across teams and services to support people.

There were systems in place to ensure all teams effectively worked together. There were daily handovers and regular staff meetings, so information about people could be identified and shared. There was evidence that showed the service worked with external health professionals to ensure they were meeting people’s individual needs.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

People and relatives confirmed their health needs were met and considered during their stays. Relatives confirmed they were responsive if people became unwell at the service and they were updated.

Staff were able to describe when they took the lead to support a person with a health need. The person had a change to their health and although initially no concerns were identified, over a period of time the staff noticed the detrimental effect this was having on the person. During this period of time, the person’s support plan was updated and reviewed more regularly with new information from family and other professionals. New plans were designed to log and monitor this and how it was affecting the person’s health. Staff were then able to evidence change in behaviours, loss of appetite and weight loss. With consent from the person and their family, staff were able to contact the consultant’s secretary to request an appointment, to consider potential surgery. A meeting was held and with the evidence the service had gathered and with perseverance surgery was completed. The staff reported how the persons quality of life had improved as a result, they said “[Person] is now putting on weight, enjoying food again and his anxiety is reduced.”

People’s health needs were assessed, and plans were in place to monitor these conditions. The registered manager told us they had developed unique plans to manage people’s epilepsy, administration of rescue medicines and when people used a Percutaneous Endoscopic Gastrostomy (PEG). A PEG is a soft flexible tube inserted through the abdomen into the stomach, used to deliver nutrients, fluids and medicines directly bypassing the mouth.

Staff confirmed they were aware of people’s health needs and gave us examples when they supported people with this.

People had a hospital passport that detailed their needs including their communication style, mobility and health needs, along with their risks and presentation during periods of emotional distress. Staff told us they were aware of this passport and would take it to hospital with people if needed.

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

Without doubt the outcomes achieved for people were exceptional. For example, for 1 person the staff had positively reflected on their personal journey over the previous 18 months. When the person started using the service they would never go out, only eat a certain food, remained in their room whilst there and did not interact with other people. The staff team worked with the person to develop a plan which enabled the person to take small steps and achieve goals at their own pace. As a result of working toward these goals, the person now mixed with others, used the computer in the communal areas, and would ask staff If they needed something. In addition, they now went into the kitchen to choose their meal with the cook. Staff told us consistency had been the key to these successes.

For another person, due to a health condition and equipment they needed, they could only a eat a small amount of specific foods orally. Due to these restrictions, they found it difficult to eat out in the community. The staff team worked with the individual and their family to research and identify a pub which would support the persons needs. They identified a pub that was quiet and spacious, to ensure the person felt comfortable and also had the specific food available that the person could orally eat. The person, the staff team and the staff at the pub all worked together to ensure everything was safe and available for the person. The person now visits the pub regularly during their stays at Ernest Bold Resource Centre and on occasion the family have also utilised it too. They now feel they can eat out with their relation, which is something they had never done before.

Another person had a very restricted diet; the diet was shared with Ernest Bold Resource Centre via their carers based on information received from a consultant. By speaking with the person, staff identified the diet was restrictive and in places contradictive. Staff also identified that the person became ‘upset and agitated’ in the service if they wanted foods that were not on their approved list. The staff team with the person who had capacity, discussed the plan and the potential issues that could arise from not following the plan. It was agreed the person understood the risks of not following the diet, so the staff team supported the person to lead on this and arranged another meeting with the consultant. The meeting involved the person, family, staff and the consultant. It was identified and agreed through this meeting that more food options were made available for the person to eat. The person was happy with the additional food choices, and this was added to the persons plans and diet. Staff reported that when the person attends Ernest Bold Resource Centre they are happier, with better moods, have lost weight and feels more in control.

Regular review of care, audits, reflective practices and goal setting ensured people’s outcomes were consistently monitored. The management and staff team were always striving to improve the service and make things better for people. There was an emphasis from staff on how people could be supported to maintain and develop new skills.

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

Capacity assessments and best interest decisions were in place when needed to ensure the Mental Capacity Act was applied. Staff had received training in this area and were aware of the processes to follow.