Coldwells 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 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 provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Assessments of people's needs had been carried out prior to people using the service and involved the person and, where appropriate, their relatives and healthcare professionals. This ensured the service was able meet the person's needs and preferences. All relatives interviewed confirmed they felt involved and well informed about the care and needs of their family members. Care plans and risk assessments had been developed and regularly reviewed to ensure they provided staff with clear guidance on how to safely support people.

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 provider ensured regular monitoring of people’s health needs took place through the use of nationally recognised assessment tools. For example, records showed use of the Malnutrition Universal Screening Tool (MUST) to identify where people may be at increased risk of weight loss and associated complications. Where risks to people were identified, the service took appropriate steps to mitigate these. The provider demonstrated a commitment to continuously review their assessment tools in line with legislation and current evidence-based good practice.

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 and relatives told us they were supported to have access to health care professionals such as GP's and district nurses when needed. This ensured people were supported to maintain their health and well-being needs. Care records demonstrated when health care professionals had been involved in people’s care. Staff knew the people they supported well, and there was a stable and continuous staff team at the service. Relatives gave positive feedback about staff at the service. A relative told us, “Everybody in here knows what’s happening, ask anybody and they can update you.”

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 were supported to access regular health appointments and medication monitoring and review meetings. When professional advice was given, this was clearly documented in people’s records and followed by staff.

Care records captured the support people required with their health needs. Staff understood people’s health needs and were aware of what action they should take when there was any deterioration in an individual’s health. For example, staff knew how to escalate concerns and seek medical advice as required.

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 systems and processes in place to monitor people’s care, to aid improvement and increase positive outcomes for people. Staff told us they were familiar with people’s known patterns of behaviour that could indicate distress or unmet needs, and used this insight to provide timely, appropriate support. A member of staff told us, “I think it is really important to check with the resident what they would like to be done, check what the right routine is, and check their care plan. Some residents go for walks, to garden centres and trips. Other residents are unable to leave their rooms, so they enjoy one to one time, such as doing nails and spending time with them. One person just likes to be assisted outside to smoke his cigars.” Care plans were detailed, personalised and provided guidance to ensure outcomes could be met; ensuring people received safe, consistent and effective support. There was a system of regular evaluation of risk assessments and people's care plans. Reviews were carried out regularly with people to ensure people's support and outcomes were monitored and in line with their wishes.

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

People’s capacity was assessed, and the principles of the Mental Capacity Act 2005 (MCA) were followed. Staff and managers were knowledgeable about the legislation and legal requirements necessary where people were no longer able to make certain decisions independently. The provider demonstrated an understanding of consent to care and the importance of ensuring people’s wishes were still considered when they were no longer able to voice these for themselves. Assessments were carried out, around people’s mental capacity and care records contained relevant information. Records captured all the relevant others involved in Best Interest decision making, where people did not have the mental capacity to give consent. Staff received training in MCA and understood its principles. A member of staff told us, “MCA is about ensuring that all service users make their own choices, and allowing them to be as independent as possible, making their own decision, not making decisions for them.”