Wall Hill Care Home Limited

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 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 67 (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 did not consistently ensure people received effective care and treatment. Advice from health professionals was not always followed or recorded. Whilst care and support had improved in several areas; further improvement was needed to ensure health professional guidance was implemented and documented.

One person had received advice from a health professional regarding a specific health condition. Staff had not recorded whether this advice was being followed, and neither was this being monitored. Following feedback, the provider introduced a new monitoring system to address this.

People’s care needs were regularly assessed. However, some care plans required updates to reflect people’s current needs. In response to feedback, the provider introduced a care plan auditing process.

Relatives confirmed people’s needs were assessed and they were kept informed about care and support. Staff reported receiving daily handovers and having access to care plans, which supported their understanding of people’s needs.

The provider worked with people to plan and deliver care and treatment, taking into account what was important to them.

During the previous inspection, concerns were raised regarding moving and handling practices, along with mixed feedback about meal preparation. This inspection identified considerable improvement. Observations showed people were supported safely, with dignity and respect during moving and handling support. New kitchen staff had joined the service. People and relatives spoke positively about the meals, describing them as high quality. People were seen enjoying their meals, which looked and smelt appetising.

Staff confirmed improvements in practice. One staff member said, “It's a lot better, we [staff] have noticed people are eating more, the presentation of the meals has improved.” Staff were observed engaging with people, asking about their meal preferences. Where people were unsure, staff showed patience and encouraged decision-making.

The provider worked effectively across teams and services to support people. Visiting professionals reported improvements within the service. Although some noted further progress was needed, feedback generally indicated the provider was moving in a positive direction.

One visiting professional highlighted improvement in the use and availability of equipment. However, they noted occasions where advice and recommendations had to be repeated and followed up. Positively, they shared they always felt welcomed into the service and supported by care staff and the manager.

Another visiting professional said, “I feel the manager listens and responds quickly.” A further professional commented, “The staff are kind and caring.” They went on to praise the management of medicines. However, they also noted the provider could be slow to act on recommendations, although commented how improvement was evident.

Relatives confirmed the provider worked well with health professionals and communicated effectively. One relative said, “[My family member] has the nurse come in regularly, they let me know and always give me an update.”

Staff described improvements in teamwork and morale. One staff member said, “Staff morale is so good now, we work well as a team. We speak to a lot of visiting professionals, it's important to make them welcome and listen to their advice.”

The provider supported people to manage their health and wellbeing, promoting independence, choice and control.

Relatives told us the provider encouraged people to live healthier lives. One relative said, “They [staff] try their hardest to encourage [my family member] to stay as healthy as possible.”

Staff were observed actively encouraging people to eat nutritious meals and stay hydrated. An external professional visited the home and led an exercise programme. People were seen participating with enthusiasm, and it was clear they enjoyed the activity. The professional told us they visited weekly and had noticed improvements within the service.

Staff reported having more time to engage with people, supporting them to take part in activities which helped maintain mobility.

Records showed the provider monitored people’s health. However, some gaps were identified in monitoring documentation. The provider explained some people occasionally declined care tasks, such as being weighed. Although this was acknowledged, clearer documentation was needed to reflect the reasons. The provider addressed this with the staff team.

The provider did not consistently monitor people’s care and treatment to support continuous improvement. Although several areas had improved, including repositioning and hydration and nutrition monitoring, concerns remained around the monitoring of people’s weights, oral care and catheter care. The provider responded to our feedback by introducing new systems to address these issues.

Relatives told us staff regularly monitored their family members. One relative said, “They closely monitor [my family member] and their mobility. [My family member] struggles with their mobility, so I telephone staff the day before I arrive and they give me an update so we can decide together whether it's safe to take them out of the home for the day.”

Staff spoke about the importance of monitoring people closely and reporting any concerns promptly.

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

Mental capacity assessments were completed in line with the Mental Capacity Act 2005. This legislation provides a framework for making decisions on behalf of individuals who may lack capacity. People were supported to make their own decisions wherever possible. Where capacity was lacking, decisions were made in the person’s best interests and in the least restrictive way. Best interest meetings were held to support decisions, such as relating to personal care and accommodation.

People told us their rights were respected, and they were able to make their own choices. One person said, “I can do what I want to do. I can eat what I want to eat.”

Staff confirmed they respected people’s decisions. One staff member said, “People can do what they want to do. It's important to ask permission before you support them.”

Although assessments and processes were in place, ongoing oversight was needed to ensure documentation remained clear and consistently reflected people’s involvement in decision-making. For example, where people declined oral care support from staff, this needed to be clearly documented in the care records. The manager responded to our feedback by addressing this with the staff team.