Moorhead Rest Home

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• 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 requires improvement. At this assessment the rating has changed to 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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People and their relatives told us they had been and continued to be involved in the care planning process. One relative said, “I am involved in [persons] care plan with their keyworker and in over 2 years [person] has been here I have always been kept up to date.” Staff spoke of how they were kept informed of people’s changing needs and how people were involved in the care planning process. One staff member said, “We have regular handovers. We write care plans alongside people and relatives. Staff have time to read people’s care plans and family can access care plans whenever they want from home.” The registered manager told us, “People and relatives are involved in developing and reviewing care plans. Reviews are conducted regularly or when needs change. Management audits and observations ensure care delivery meets assessed needs.”

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 their relatives were complimentary of the food on offer. One relative said, “[Person] enjoys the home cooked food and likes a chat with tea and biscuits.” Another relative commented on how a person ‘picks at their food’ and how staff monitor for signs of weight loss. Staff spoke of the importance of nutrition monitoring. They said, “We complete monthly weight audits and refer to the dietician, when needed. The meals always smell nice and look appetising. People seem to enjoy their meals and most people finish them. There is a menu with 2 options, but we also have an alternative menu. It is relaxed here; people can eat when they want. There is no budget or restrictions.”

We observed the food to be presented well and looked appetising. Menus were displayed in the dining room on the wall and on individual tables and included pictures. People appeared to be enjoying their meals, and staff were present to offer assistance and encouragement. Guidance was available in the kitchen to guide the chef of people’s specialised diets including people who are diabetic or have modified diets.

The service worked well across teams and services to support people. Relatives told us they were kept updated of a person’s change in care provision and of any incidents that may occur. They said, “I am always kept up to date with any changes or medical appointments.” Staff told us that team working had significantly improved in recent months and that staff were on hand to help each other out when needed. We saw evidence of referrals being made when people became unwell to the GP or specialised healthcare services in the local area. The registered manager said, “We maintain strong communication with external professionals such as GP’s, nurses and social workers. Information is shared appropriately to ensure coordinated care. Continuity is ensured through consistent staff teams and detailed handovers.” Partner feedback indicated strong relationships with themselves and the service and they felt they would be kept informed of any concerns the service may have about people.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. People told us they were supported to attend medical appointments and one person spoke of how staff offered emotional support following an appointment. Staff told us they could provide care in a calm and relaxed way and spoke of the importance of ensuring people lived healthy lifestyles. One staff member said, “We are able to spend a lot of time talking to people. It is very relaxed and there is no pressure. We promote healthy lifestyles through exercise and healthy eating. We always offer fruit as a snack.” The registered manager told us people’s health was monitored through regular observation, health checks and referrals to healthcare professionals, when needed.

The service did not always routinely monitor people’s care and treatment to continuously improve it. Tools for monitoring outcomes were not always robust. Charts evidencing people’s distressed behaviours were not detailed enough to review the risk and how this may impact on the person. Although this had been rectified during our site visit, we found this concern at our previous assessment. This meant we could not be assured this practice had been fully embedded. Oral health care plans were in place and detailed the level of support people required, however, there was limited evidence of people attending dental services.

Staff told us how people’s food and fluid intake was monitored. They said, “Food and fluids are logged for everyone. I look at what has been offered but more importantly I look at how much fluids people are drinking. If I don’t think people are drinking enough, I contact the GP or dietician for advice.”

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. People told us they had consented to their care and treatment and relatives spoke of signing consent forms when required. We saw evidence of consent forms in place for various areas including medicines and consent to care and treatment. Staff told us they always gain people’s consent before any care interventions, and we observed staff asking for people’s permission before they performed tasks such as helping to put on glasses or assisting people into a chair. We did however, see limited evidence of people’s capacity being assessed in certain areas such as medicines and restrictive measures.