Healey 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 assessment we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff ensured care plans were extremely detailed, and temporary protocols were in place when people were going through changes which impacted the level of support or strategies needed. For example, during a change in health or following a family bereavement. This enabled staff to give truly tailored and person-centred care when people needed it most.

‘This is me’ information clearly captured what was important to people, including details of their personalities, preferences and preferred routines. One person living at the service needed a strict routine to prevent anxiety or distress. Information about their various routines was robust, and stressed the importance of structured support and predictability on the person’s wellbeing. During inspection, we observed the person to be happy and settled as a result of consistent, holistic support provided by staff in line with their care plans.

The registered manager explained that relatives and people were involved in care planning, “From the start”. There was evidence of care planning documents being signed by relatives before being introduced, and of regular contact when people’s needs were being reviewed. Where required health and social care partners, or advocates 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 registered manager and deputy manager kept themselves up to date with changes to best practice guidance and legislation by attending various forums and webinars, and signing up to mailing lists.

Information about people’s nutrition and hydration needs was included in their care plans, with clear guidance for any adapted diets or support requirements. Staff could explain the different levels of help people needed with eating and drinking.

People’s food and fluid intake was recorded for those who needed it, and records showed they received a good level of fluids and a variety of foods. Those at risk of malnutrition were monitored closely and healthcare partners were consulted if people were losing weight, or they were having difficulties with eating and drinking.

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.

There was a communication book, handovers at each shift change and regular team meetings, to ensure information about people and any changes to their health and care needs or wellbeing was shared effectively.

The service had systems to share communication from healthcare partners amongst the team, and any guidance or information about delegated tasks was included in people’s care plans, risk assessments and protocols.

Managers and staff were proactive when working with healthcare partners, with information being shared effectively. A healthcare partner told us, “The service is excellent at providing a joint working approach. The staff are person-centred in their care and in frequent communication when anything changes. When a change in support has been required, the registered manager took timely action to ensure that additional support was attained.”

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

There was evidence of regular involvement from healthcare partners, and referrals were made in a timely manner when people’s needs changed. A healthcare partner told us, “The service are efficient in making the appropriate referrals to the appropriate services.”

Staff supported people proactively before their healthcare needs changed. For example, 1 person’s mobility was reducing due to a progressive illness. The provider had renovated a downstairs office into a bedroom to ensure they could continue to live at the service safely. Additional equipment and staff training had been implemented to ensure their changing health and care needs could be met.

Managers and staff helped people understand and prepare for any changes to their health, upcoming appointments or treatments, by sourcing information in accessible formats and having conversations with people at their level. This helped people have more choice and control over their own health.

Staff were proactive and championed people accessing healthy living options; including exercise, a good diet and hydration. The service had organised water aerobics sessions at a local pool, ensuring measures were in place to reduce people’s anxiety and distress about this. People also attended several adapted exercise sessions or went walking in their local community to improve their health and fitness. A staff member explained how people were encouraged to use the stairs, instead of the lift, to help maintain their mobility.

People were encouraged to eat a healthy, balanced diet where required to improve their general health, weight or mobility. One person explained proudly they had recently started drinking bottled water instead of soft drinks, to be healthier.

The provider proactively 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 service used various systems to monitor people’s health and the effectiveness of their care and treatment. For example, people’s behaviours, weights, seizures, skin integrity, bowel and urine output. Staff monitored people more thoroughly, ensuring detailed records were made when people had upcoming appointments or reviews with healthcare partners, to help inform decision making and treatment plans. During our visits a person’s eating was being monitored closely prior to an appointment with the speech and language team. Staff had recently been complemented on the level of detail for a person’s night-time patterns, in preparation for a medication review.

The registered manager showed us a person’s seizure records, designed to capture the number, type and severity of seizures to support annual health consultations and reviews of their care. They explained the person's support was regularly adjusted to ensure they could continue to do the things that mattered to them and have the best possible quality of life. Their relative confirmed the person had a busy timetable despite the high number of seizures, telling us their care was, “10 out of 10.”

One person had been wrongly diagnosed with a health condition and staff did their own research when treatments did not seem to be working, advocating for the person for a prolonged period of time to have a second opinion. It was confirmed their initial diagnosis had been wrong and treatment plans were reviewed as a result.

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment.

The provider had excellent systems to ensure consent was sought. Consent forms were signed by people or their relatives. Decision specific mental capacity assessments had been completed, and detailed best interest decision making records were in place.

Staff received training in MCA and could tell us who had capacity and how they sought consent. Care plans prompted staff to involve people in decision making and included a check list detailing the level of capacity people had to make different decisions. For example, day-to-day decisions about what they wore or how they spent their time, or larger decisions about their health, care or finances.

People were consulted and kept informed at a level they understood, with their views being considered when decisions were made about them. If people lacked the capacity to make decisions themselves, relatives, advocates and relevant person’s representatives helped support decision making and ensure their best interests were considered

The registered manager worked closely with relatives and advocated for someone who had an hospital imposed Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) placed on them. DNACPR means if a person had a cardiac arrest or dies suddenly, there will be guidance on what action should or shouldn’t be taken by a healthcare professional, including not performing CPR on the person. The proactive actions of the registered manager meant this person was no longer subject to an unnecessary and inappropriate decision about their treatment.