Speirs 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 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 and where appropriate, their relatives, were involved in planning and reviewing of the care delivery. People’s comments included, “They keep me up to date with everything, nothing is missed or covered up. That’s what I like, they don’t try to hide things, even if it is negative” and “[The home] do ask if I’m happy with things from time to time.” A relative said, “There is a care plan, and it is all OK. The review is an on-going thing.”

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. People had support to eat and drink in a way that met their choices anddietary requirements.Comments included, “[Staff] like to keep you well fed here, there always seems to be something to eat on offer. They keep you hydrated too they’re very strict, checking that you are drinking enough” and “My relative cannot eat normally now, [the person’s] food is pureed but [staff] still make sure it is appetising and that it tastes good. The food is lovely.” We saw people being provided with individual choices for meals where they didn’t like what was offered to them. The management team told us they were in the process of developing a pictorial food folder to support people’s daily choices and if the picture was not yet available, staff showed people the meals to choose from.

The provider worked well across teams and services to support people. Staff told us they worked well as a team making sure people’s care needs were always met. They said, “Personally, I feel it's working here well. It’s team working and all staff that are here are working together.” Systems were in place to ensure good information sharing between the staff team. Daily staff meetings and handover sheets were used to plan the support people required and to discuss any changes in their care needs.

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 had access to healthcare as necessary.Their comments included, “The GP comes every week, she was here today. For hospital appointments [staff] will call a mini cab. If I request it, a carer comes with me.” People were supported to have regular dentist and optician check-ups.

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. Staff were aware of people’s care needs which ensured they supported their well-being.A family member told us, “I certainly am happy with the level of support, [staff] know my relatives well.” Comments made by the healthcare professionals included, “I have recently completed 2 visits to the service and both times witnessed a skilled and supportive approach from the staff team, who appeared to know the residents well and how best to support their needs” and “On examination, [people are] well looked after and in good spirits.” Staff used guidance and advice provided by the healthcare professionals to ensure they assisted people with the right type of support.

The provider did not always ensure people had their rights around consent respected when delivering care and treatment. Mental capacity assessments were completed by the service supporting people to make important decisions to them. Where it was decided that a person lacked capacity to make the decision, a best interests meeting took place making sure the person's best interest were adhered to.The registered manager told us they worked in partnership with the healthcare professionals to support people in the decision-making process. However, records showed that the service had not always adhered to the Mental Capacity Act 2005 (MCA) principles as necessary. Following the mental capacity assessments and best interest decisions, they requested family members without any legal powers to sign a consent form on people’s behalf where they lacked the capacity to decide themselves. This was in relation the use of bedrails for a person. We discussed this with the management team who told us they followed the provider’s process and that this practice would be reviewed making sure the legal requirements of the MCA were applied as necessary.

Staff were aware of the MCA principles. Staffs’ comments included, “If [people] don’t have the ability to make decisions, the best interests decision is done in these cases. We don't assume [people] don’t have capacity” and “The MCA means that everyone has a right to have capacity, make unwise decisions and in the least restrictive way. It's about giving residents choices and the right to make unwise decisions.” We saw the MCA principles displayed on various notice boards at the service as a reminder for staff to apply the MCA in practice.