Albert 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 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 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.

People's health, communication, nutritional, cultural and support needs were assessed and documented. Staff had access to specialist assessments and professional guidance to help meet people's needs. For example, staff recognised and responded to a person's dietary allergies and cultural requirements, and specialist guidance informed support for communication, eating and drinking, nutrition and sensory needs.

Systems were in place to assess and monitor nutritional and health related risks and records demonstrated staff monitored changes in people's needs. However, some assessment records were not always consistently reviewed and updated when people's needs changed. Some health and communication records did not fully reflect more recent healthcare information or professional guidance. This meant records did not always reflect people's current needs as clearly as they could. Despite this, our observations demonstrated support was delivered in line with people's assessed needs and specialist guidance.

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.

Staff worked with a range of health professionals to support people with complex health needs. Professional guidance, including Speech and Language Therapy (SALT), dietetic, physiotherapy and occupational therapy input, was incorporated into care records and day-to-day support. People's dietary, allergy and dysphagia needs were recognised and reflected in meal preparation, eating and drinking support, and specialist healthcare interventions. Staff demonstrated awareness of people's individual health needs and how specialist equipment and clinical support should be used safely.

The provider responded positively when concerns were raised regarding a person's prolonged bed care and sought additional specialist input to support future care planning. However, changes to professional guidance and people's assessed needs were not always reflected consistently across records. For example, some information relating to allergies and eating and drinking guidance differed between documents. Despite these inconsistencies, observations demonstrated staff were working in line with current professional guidance and people's assessed needs.

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 worked effectively with a range of healthcare professionals to support people's changing needs, including GPs, community nurses, dietitians, physiotherapists, occupational therapists and Speech and Language Therapy (SALT) services. Staff sought clarification and additional advice when required to ensure people received appropriate support. For example, following a person's discharge from hospital, staff worked with healthcare professionals to clarify nutritional supplements, continence support and eating and drinking guidance.

Effective communication was evident between staff, healthcare professionals and other services involved in people's care. Staff worked well together and demonstrated effective teamwork when supporting people with complex needs. Observations showed staff shared information, sought advice from colleagues and adapted their approach when people required additional support. External healthcare involvement was coordinated and followed up appropriately.

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 maintain their physical health and wellbeing. People had access to physiotherapy and other health professionals where required, and staff encouraged people to maintain mobility and physical activity where safe to do so. We saw how staff supported one person to take steps independently and used encouragement and positive reinforcement to promote mobility and maintain existing skills.

Systems were in place to monitor nutritional wellbeing and health related risks. Staff followed professional guidance to support people's health needs and worked with healthcare professionals where changes in need were identified.

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.

Systems were in place to monitor people's health and well-being over time. Staff monitored changes in people's health and responded to emerging concerns. Positive outcomes were identified and recorded, including improvements in a person's weight following a prolonged hospital stay and healing of skin concerns following monitoring and intervention by staff.

Staff demonstrated awareness of the impact that equipment, adaptations and interventions could have on people's well-being and engagement. For example, a staff member identified that one person appeared more engaged when using glasses and took action to ensure they were available and used.

Whilst changes in people's health and well-being were recognised by staff, records did not always demonstrate how information gained through monitoring was used to evaluate outcomes and inform future support. Records did not always show how these changes were consistently reviewed, communicated across the staff team or incorporated into ongoing support arrangements. In addition, some records relating to people's goals and aspirations did not clearly demonstrate how progress, outcomes and effectiveness were evaluated over time. Despite this, there was evidence that staff identified changes in need and took appropriate action when concerns arose.

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

Staff sought consent and involved people in day-to-day decisions using the communication methods available to them. Mental Capacity Act (MCA) assessments and Best Interests decision making processes were in place for key decisions. People with complex communication needs were supported to participate in decisions about their care and support through observation, knowledge of their communication styles and consultation with those who knew them well.

Improvements had been made since the previous inspection regarding the legal framework used to support the management of people's finances. Decision specific MCA assessments and Best Interests records demonstrated consideration of less restrictive options and consultation with family members where appropriate.

Records did not always clearly demonstrate how relatives' views had influenced decisions or how ongoing expenditure decisions reflected people's wishes and preferences. Despite this, appropriate MCA assessments and Best Interests decision making processes were in place to support lawful decision making.