Maiden Castle House

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 inspection we rated this key question requires improvement. The provider had embedded and sustained improvements and safety with people’s nutritional needs. At this inspection 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 service 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 into the service. Assessments were carried out with the person, relatives and healthcare professionals, they were used to create care plans. This had enabled a smooth transition into the service. People told us they could contribute to their care plans. Staff had access to information about people’s needs, through the providers electronic care planning system.People’s records were accurate to the care they were receiving. Staff said they had enough information to support people and understood individual requirements and preferences. Care plans and risks assessments were reviewed regularly and updated when required.

The service 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.

People and where appropriate, their relatives were involved in creating care plans and risk assessments, they told us they could ask to change information when they needed to and said they were kept informed. Staff knew how to support people’s mobility and medical conditions. Guidance from healthcare professionals was incorporated into people’s care plans. The registered manager told us about their implementation of the nationally recognised initiative to reduce caffeine intake in care services to reduce falls in older people. This had been rolled out across the providers locations and had seen positive results with the changes potentially reducing the occurrence of falls. The provider was actively working with specialists to improve services for people living with dementia and had further improvements planned in this area of care.

The service 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 and their relatives were satisfied information was shared appropriately within the service and outside to health professionals as required.Information was shared confidentially, for example with the GP or nurse and staff were reassured in their working relationships with external professionals. A relative told us, “I am fully involved in my loved one’s care, we do everything as a team and the home ensures I am part of any decision. Nothing is done without my involvement.” People had a ‘hospital pack’ that contained important information such as, medical history, current health, medication and the person’s needs. This supported smooth transitions between medical services. The service worked with a variety of healthcare professionals, such as, district nurses, chiropodists, GPs and pharmacists. Information and direction from these health care professionals had been added into people’s support plans. We observed staff following this. A healthcare professional told us, “They are a pleasure to work with on a daily basis.”

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were encouraged to live a healthy lifestyle. People were complimentary about the food on offer at the service. People said there was plenty of food, drinks and choice. Where people were supported with food and drink there were detailed instructions in care plans. Information about dietary needs were known to kitchen staff. Maiden Castle House had won, ‘best dining experience’ at the providers internal awards ceremony, the registered manager told us they were proud of the team. A member of staff told us, “I am always kept updated on people’s needs, staff are always keeping me informed.” People completed a life story document that allowed staff to know what the person liked and enjoyed, supporting health and wellness.

The service 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.

People and their relatives told us they were involved in creating care plans specific to their medical conditions. One relative said, “I will get a call to discuss changes, and will be asked for my input before anything is changed.” Care plans identified a person’s specific needs, the desired outcome and the action required to meet this. Care plans were regularly reviewed and updated. Changes and updates to care plans were clear to staff. Each plan was individual to the person and their need. People and their relatives told us healthcare professionals were involved in their care. The service had members of staff who had the role of ‘champion.’ Champions were staff with a special interest in certain areas of care including, dementia and care planning. Quarterly meetings were held across the providers locations for champions to discuss processes, results, good practice and learning.

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

People told us they were treated with respect, dignity and kindness. Where appropriate, relatives had been involved in decisions made on the persons behalf. Consent was sought from people and where necessary in accordance with the Mental Capacity Act 2005 (MCA). A clear process was in place to carry out MCA assessments where required.Records showed that people had been supported to make specific decisions and where someone lacked the ability, their family and appointed representative had been involved in a best interest decision. Staff had received training and understood the importance of asking for consent from the person. Records showed specific assessments had been carried out, this included consent for photographs for medical purposes, bed rail use, consent to care and falls prevention. We observed people being offered choices throughout the day. People told us staff were respectful and would ask them before completing a task. Relatives told us they felt staff and management were respectful to their loved one wishes.