Wold Haven

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 and care plans were comprehensive and regularly reviewed, evidencing referrals to appropriate health professionals for support when needed. For example, records showed people had been assessed to mitigate the risk of choking. These assessments included information about the types of diets (soft or pureed) and the appropriate thickness of fluids. Guidance was also provided for staff on how to support people safely, including advice on posture, the level of assistance required, and how frequently food and/or fluids should be offered. District nurses visited daily for catheter and bowel care; weight monitoring was documented and capacity‑based refusals recorded with no current concerns.

Overall relatives told us they felt involved in the care planning process and were able to relay important information about their loved ones. Records showed people’s communication preferences and detailed guidance on how best to support them.

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 completed and reviewed assessments of people’s needs. We found care records detailed the use of recognised, evidence-based tools to assess and plan people’s care, such as assessing risks for choking, skin integrity and falls.

One relative discussed how their loved one was supported to minimise the risks of choking, they said, “They [staff] thicken [name of person] drinks and they have soft foods.” Records showed some people had received a review and/ or change of their medicines to reduce potential risks.

The provider followed best practice guidance for supporting people with a learning disability and autism.

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.

Staff assessed and monitored people’s health needs; they raised any concerns to senior management who took appropriate action. Staff worked alongside various healthcare professionals to meet people’s needs, such as the district nurses and GPs.

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.

Staff supported people to have choice and control over their lives, whilst remaining as independent as they could, for as long as possible. We observed staff encouraging people to do things for themselves. Staff were careful not to take any daily living skills away from people they supported. The staff’s knowledge of people and their capabilities increased people’s health and opportunities for them to be involved in activities and events that were meaningful to them.

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.

Care plans included information about people's preferences and expected outcomes from the care they received. Both clinical expectations and the well-being of each person were detailed to capture positive outcomes and identify areas of further support.

Staff spoke with us about improved outcomes for people. A staff member said, “We pass information to our seniors from the District Nurses. Seniors pass important details to us on handovers. If I have concerns, I escalate them. [Name of person] accidentally scratched a wound and during personal care we noticed this. It was not healing, so we reported it to the senior on duty, and the District Nurse tended to this. We also had another person where antibiotics were prescribed for a chest infection.”

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

The provider understood how to apply the requirements of the Mental Capacity Act (MCA). The service considered people’s capacity to make decisions during pre- assessments, and regularly reviewed people’s capacity to make their own decisions. Best interest decisions were made with appropriate professionals and relatives, if needed.

Records showed people with capacity made their own decisions, including declining the use of some safety measures such as bedrails or seatbelts considered beneficial even after risks were explained to them. Staff articulated the Mental Capacity Act (MCA) and best‑interest processes; relatives confirmed involvement where appropriate.

Lasting Power of Attorney documentation to support decision making for finance, health and welfare for some people required updating. We discussed this with the registered manager who agreed a process to obtain these in case of any unforeseen emergency.