OSJCT Athelstan House

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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 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.

Managers completed assessments of people’s needs before they were offered a place in the service. These assessments were used to support people to develop detailed care plans, setting out how their assessed needs would be met.

The registered manager told us any of the management team could complete assessments which meant there were no delays. For example, if the registered manager was on leave, assessments of people in hospital could be completed in a timely way.

Management continued to assess people’s needs once people were using the service. This enabled changes to be identified, and care records updated.

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 could speak confidently about understanding how policy changes could make significant differences to people and their care.

The provider used recognised national tools to assess people’s risk of malnutrition and developed plans with them to meet their needs. We observed staff providing effective support and encouragement for people to eat safely and maintain their nutritional intake. Staff kept a record of food and fluid intake for people at risk of malnutrition or dehydration and escalated concerns to health professionals where needed.

The kitchen staff understood nutritional needs and could talk confidently about people’s allergies and dietary requirements. Staff completed training in nutrition and food safety to ensure their knowledge was up to date.

Feedback from people and relatives about the food was positive. Comments included, “The food here is very good, I love soups and the mushroom soup is really nice” and “[Person] is able to choose meals, and I have observed staff offering alternatives to tempt [person] if they have changed their mind.”

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.

Records demonstrated the provider worked with a range of health and social care professionals, sharing observations about people’s conditions where relevant. The registered manager told us they were able to access some GP records following a GP visit which meant they could make sure information was recorded correctly. The registered manager said this access had been very beneficial in ensuring information about allergies and medicines was correct.

There were daily handovers and meetings for all staff. Care staff attended a handover before the start of their shifts and heads of department attended a daily meeting with management. Information was shared on things like admissions, falls, safeguarding incidents and any changes of people’s 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’s health needs were recorded in their care plans with clear guidance for staff on support needed to manage health conditions. For example, if people had diabetes, they had specific care plans outlining help they might need. Any scheduled health appointments were recorded in care records and staff organised support such as transport. As GPs carried out weekly visits to the service, they spoke with people individually about their health needs, involving people in decision making where possible.

Staff carried out health monitoring such as weight management and food and fluid monitoring. Staff escalated any changes to people’s health to the relevant healthcare professionals and made sure their needs were reviewed if needed.

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.

People and relatives shared feedback with us about how their outcomes had improved since living at the service. They felt this was because of good care delivery.

Staff maintained records of care they had provided, for example, how much food and fluid people had taken or their skin condition. Records demonstrated changes were shared with healthcare professionals where needed to ensure people received appropriate treatment.

Staff monitored care outcomes and management kept oversight records of areas such as falls, hospital admissions and infection rates. The provider monitored care data to provide extra oversight of people’s outcomes. This meant, where care needs changed, the correct actions were taken. For example, if a person lost weight, this could be identified at many levels to make sure the person had support needed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff were provided with training on the Mental Capacity Act (MCA) 2005 when they started work. They were also given refresher training and a small card with the principles of the MCA recorded. This acted as a reminder for staff to refer to the principles of the MCA if they were unsure.

Management ensured people had been consulted in relation to assessing their capacity to make decisions. They had recorded how they had consulted people and how they had considered the person’s preferences.

People and relatives did not share any concerns about this quality statement. People’s records demonstrated staff had followed legal frameworks for gaining consent.