The Old School 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 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 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 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 needs were assessed prior to their admission to the service and then on an ongoing basis through regular reviews. Managers and staff understood that people’s needs frequently changed, so assessments were regularly reviewed and updated.

The interim manager said that previously, relatives hadn’t always had the opportunity to take part when reviews were taking place. This was changing, and relatives had been contacted to see if they would like to contribute. This meant that relatives, as well as people, staff, and health and social care professionals, would all be able to share their views on people’s care and support needs.

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. People’s nutritional needs were met.

The staff training programme ensured staff understood current legislation, national standards, and evidence-based good practice guidance for those working in care services.

Relatives said staff were well-trained and had the necessary knowledge and skills to provide the support their family members. A relative told us, “They have regular training days and booked courses with all the new rules and regulations that come out.”

Since we last inspected the service had employed a dedicated cook. They knew people’s dietary needs and how to minimise risks they might be subject to regarding food intake. For example, people with swallowing difficulties had food textures and drink thicknesses in line with the International Dysphagia Diet Standardisation Initiative (IDDSI).

The cook provided wholesome and appetising food with plenty of choice and variation. A relative said, “They now have a proper cook, and people are getting vegetables and better foods. We are very happy that the food is better.” Another relative told us the food was now ‘homemade and cooked in the kitchen, not processed’.

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 collaborated with a range of health and social care professionals to effectively deliver coordinated, timely, consistent, person-centred care, support and treatment.

For example, staff were trained by the Home Enteral Nutrition Service (HENS) to manage enteral feeds and followed nutritional plans put into place by a dietitian. This meant people had the specialist support and daily assistance they needed with their nutrition and hydration.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Some care records were incomplete.

Where necessary, people were weighed regularly to ensure their nutritional needs were being met. Two people who were weighed monthly had a gap of 1 month each in their weight monitoring charts. The interim manager said they would address this and ensure in future people were weighed in accordance with their care plans.

People’s health and wellbeing needs were promptly met. A relative said if staff thought a person was unwell, they took them to the GP to find out what was wrong. They also took people to hospital when needed. Another relative told us, “The GP comes regularly and other healthcare providers – SALT [the speech and language therapy team], physio and dentist.”

A relative described how staff provided ‘exceptional care and support’ when a person was in hospital. They said they were told which staff member was with the person, the ward they were on, and given a phone number to talk to staff at the service to get updates at any time. They were also told the person’s prognosis from the doctor, and what was going to happen when they were discharged. The relative said, “It’s about advocacy, and as a family we feel well advocated for by The Old School House.”

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.

Staff worked with health care professionals to reduce risk and improve outcomes for people. For example, a person was referred to SALT due to being at risk of choking. As a result of staff following SALT advice, the person’s risk of choking was reduced, and they were able to eat and drink in a safer way.

Two people were sharing a room at the service and had done for many years. The interim manager said that both people and their relatives/representatives had been consulted about this arrangement. However, there was nothing recorded to confirm that this was their choice or in their best interests. The interim manager agreed to address this. Staff worked with the local Deprivation of Liberty Safeguards (DoLS) team to ensure that any deprivation of liberty was necessary, lawful, and compliant with the Mental Capacity Act 2005 framework, prioritising the least restrictive options wherever possible. Staff communicated with people about their choices. If people did not use verbal communication, staff used different communication methods, for example, objects of reference, sign language, and visual aids. People and their relatives were actively involved in decision-making. Relatives told us staff contacted them when ‘best interest’ decisions needed to made.