121 Watleys End Road

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 care and support needs were assessed before they moved to the home. This was comprehensive and involved the person, their representative and health and social care professionals. The assessment then enabled the staff to write a more detailed care plan to support people.

People’s communication needs were clearly recorded in their care plan, enabling staff to get to know each person including their likes and dislikes. Each person had a 1-page profile enabling new staff and agency staff to get to know people. This included important information on how people communicated, their preferences and interests. More detail was in the care plan guiding staff on how to support each person with all aspects of their care and support. Where gaps were identified during this assessment, the provider had taken action as described in the safe domain.

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.

Nationally recognised tools were used to assess and plan people’s care. People using the service had their nutritional needs assessed where appropriate. Information about people's preferred foods and drinks, food allergies, likes and dislikes were recorded. If any needs were identified with eating or drinking people were referred to the appropriate health care professionals for advice and support.

During the assessment we found some inconsistencies within the care plan and daily records for 1 person in respect of how many scoops were required for thickening their drinks and for another person whether they were being offered pureed food. This was addressed during the assessment. Neither person had come to harm.

People were referred to the community learning disability team in respect of guidance to support them with their epilepsy and moving and handling protocols. Health professionals were observed visiting on all 3 days of the assessment spending time with staff and the people they were supporting.

The provider was actively working with a family representative to support a person based on the wishes of the family. The team were ensuring it was in the person’s best interest and ensured their safety, whilst taking into consideration guidance from professionals. Whilst this had been an ongoing concern for the family a meeting had been arranged to discuss further, involving an independent advocate.

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. People’s relatives told us the staff team always kept them informed about any healthcare appointments and the outcome.

The GP visited the service on a weekly basis to complete a ward round and see people where needed. Records showed staff were well prepared and maintained clear records of any changes to people’s care or medicine changes. One professional told us, “I love visiting 121, they do an amazing job, nurses always provide an update, staff can be busy, but they know the residents really well.” However, 1 professional said that communication could be difficult and sometimes they received conflicting information depending on who they were speaking to. They said this had improved recently as the home is using less agency staff and new staff were more familiar with the people living in the home. They also acknowledged some staff may have more experience with some people more than others.

Staff confirmed daily handovers took place to ensure care was planned and they were kept informed of any changes. Staff told us they could access people’s care plans enabling them to keep up to date with what was happening in the life of the person they were supporting.

Staff reported the team worked well together. Staff worked in pairs to support people to deliver personal care. Staff confirmed there was good communication between the nurses and care staff ensuring people received care that was effective and responsive.

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.

Each person had care plans about their health needs, so staff had the information needed to help them remain healthy and active. Staff had completed training in recognising the signs of a person being unwell called RESTORE2. Many of the people were unable to communicate verbally if they were in pain. Care plans included how each individual expressed this.

Nutritionists were involved in people’s care to ensure their dietary needs were met via their Percutaneous Endoscopic Gastrostomy (PEG). A PEG feed refers tonutrition and fluids delivered via a Percutaneous Endoscopic Gastrostomy (PEG) tube. Staff had received training to ensure they were competent to support people in this area.

The staff completed food and fluid charts to ensure people’s nutritional needs were being met. These were monitored to ensure people’s intake was appropriate to reduce the risks of dehydration and malnutrition.

People were encouraged to participate in gentle exercise to aid movement, and people were supported to have bed rest where relevant to reduce the risks of pressure wounds developing. This was important where people were seated in specialist wheelchairs for much of the day. Staff supported people to move around their home and spend time in the lounge, their bedroom and the garden in the warmer weather.

One person was supported to go swimming on a weekly basis to help with mobility. A relative said that they would like their relative to go swimming, but they were aware there was a waiting list for the specialist hydro pool. They said this had been in place before COVID, but this has stopped along with another social club that happened in the evenings. Staff confirmed they were on a waiting list to access the hydro pool as this would be beneficial for others living in the service. They also told us as part of the home’s action plan they were reviewing activities both in the home and the local community.

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.

The provider had recently completed a team away day to discuss the culture within the service and team morale. The provider put in place an action plan to monitor actions to improve outcomes for people living in the home. This included re-introducing a key worker system where a dedicated member of staff would be allocated to each person. This had been introduced and now each person had a named nurse and a member of the care team. Staff spoke positively about their roles in supporting people to achieve their goals and aspirations. An example was where a person had reconnected with a friend they previously lived with and some people had been supported to go on holiday with family or in a small group.

Staff recognised improvements were needed to ensure people were supported with activities both in the home and the community. A staff member told us external entertainers had been booked monthly. They told us people particularly liked the music events. Activities were clearly displayed on the notice board. We observed staff organising activities on the days we visited the home. This was still being embedded to ensure people had equitable access to regular activities as not everyone was supported to access the community on regular basis.

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

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, this is usually the Deprivation of Liberty Safeguards (DoLS). Not everyone had a care plan about how they consented to care and support or information about any Deprivation of Liberty Safeguards. This was fed back to the provider who took immediate action to address this.

Staff understood the importance of seeking consent and involving people in day-to-day decisions. Where a person declined care, it was evident this was respected but followed up to ensure their health and support needs were met. For example, a member of staff who knew the person well would assist.

Staff had received training in the Mental Capacity Act. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. Where people lacked the capacity to make certain decisions, assessments had been undertaken and best interest decisions made on people's behalf. Relatives and health and social care professionals had been consulted and involved in the process.