Casa Mia Care Home

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 changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them. Pre assessments had been completed prior to a person moving into the service to ensure Casa Mia Care Home could meet their needs and preferences.

People were at the heart of their care planning, and we saw evidence, where possible, people had taken autonomy with how they chose their care to be delivered. Relatives and healthcare professionals were also involved and informed. Care plans contained the information staff needed to provide safe care and support, and there was a focus on the information being person centred. Staff had daily handovers to share important information about people and any changes in their support needs. Relatives told us, “I can talk to any of the staff about them, they are all so brilliant. They talk to me and (person) about their care here”. Another relative said, “I’m aware of care plan and they update us of changes to care plan”.

The provider always 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. They worked to develop evidence-based good practice and standards. Nationally recognised assessment tools were used to assess people’s risks of malnutrition and their risk of skin deterioration. Where staff identified risks, they implemented appropriate control measures. For example, some people were monitored to maintain a healthy weight, staff discussed this with them to enable people to have an awareness of their health needs. A person told us, “I have been losing weight, and I am now weighed weekly to monitor this. I sometimes eat a meal with my neighbour, and they will cook me a soup”.

Some people had specific food monitoring charts to encourage them to have a greater understanding of what macronutrients they needed to meet their nutritional needs. Macronutrients are the three main components of food which give your body energy: carbohydrates, protein, and fats. Where people required specific modified diets, guidance was clearly available across documentation within the service, to ensure staff followed a consistent approach. One relative told us, “The food is amazing, but they have their own kitchenette too, sometimes they will go to the dining room, or they will do scrambled eggs on toast in their room, they choose. Staff support them to purchase their own groceries and help with making their meals”. Another relative said, “They are a diabetic and on medication for this. I think it’s all under control now. They know exactly what they can and can’t eat. They have capacity to make their own decisions and staff support and respect that. They listen to them”. Staff supported people to grow their own fruit and vegetables at their request, 1 staff member told us, “[Person] has their own garden they are growing potatoes and green beans; they take them to the kitchen for lunch for everyone to enjoy. They enjoy watering them with another person every night too”.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

People accessed external healthcare professionals, and care plans evidenced the relevant referrals had been made where required. Leaders, staff and external professionals collaborated closely, fostering a strong culture of shared responsibility. This integrated approach delivered timely interventions and consistent, holistic care. Leaders and staff maintained proactive, effective communication with healthcare professionals who had built relationships with local healthcare services. Although we received limited feedback from healthcare professionals, 1 health care professional told us, “I could ask staff anything about [person] and they would know it, everything we have agreed for the person has been done. Casa Mia is always discussed for placements or success stories; they are always positive stories. I would definitely feel comfortable raising any concerns and approaching managers, although I’ve never needed to. The staff are all so knowledgeable about [person] needs. If we have an assessment for a person, Casa Mia is always our first choice, Casa Mia stand out for us”.

The provider always supported people to manage their health and wellbeing to fully 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 had access to regular healthcare professionals, these included the GP, mental health team, speech and language therapists, dental access and opticians. People spoke positively about how Casa Mia had improved their mental health, one person told us, “My mental health is more stable here, as stable as it can be. Staff have helped me be more confident and less stressed”. Another person said, “Staff are all good listeners especially if I’m stressed. If they have the time, they play games with me”.

Some people found it difficult to attend regular healthcare appointments which had an impact on their required healthcare monitoring. The provider facilitated some staff to complete phlebotomy training to enable people to have regular blood tests in their own home. Staff spoke of what a positive impact this had had for people. One staff member told us, “Some people find visiting surgeries or hospitals difficult, so staff completed Phlebotomy training. Blood tests can be taken in house and sent to the surgery each month which alleviates the stress and anxieties for some people”. They told us this had also been beneficial for when people required blood tests to monitor certain types of medication levels.

People and relatives provided us with multiple stories of how since their loved one had moved to Casa Mia Care Home, their overall health had improved. One relative told us, “Before moving to Casa Mia [person] wasn’t engaging and spending days in bed. Then a miracle happened, they started spending more time out of bed, than in bed. Within a short time, they were a different person, the service they offer is world class. From our perspective its absolutely amazing, families are involved in open days, invited for curry's, they encourage them, they are so different to now. They have done an amazing job”.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Care plans and risk assessments contained information about people’s health and wellbeing and were regularly reviewed. Daily recording of people’s needs identified changing health care needs, progression and where improvements had been made. Relatives shared multiple examples of how the service was monitoring and improving outcomes for people and how this had made a significant positive impact on people’s lives. Relatives shared comments of, “They are much happier here than they were in hospital. They have told me they are so much happier and more settled here, their quality of life has improved significantly”. Another relative shared, “They can’t do enough for them here. Their mood has changed in the short time they have been here. It’s much better than it was when they were at home”.

A senior staff member carried out monthly healthcare checks with people who consented, this had identified when some people had high blood pressure, which resulted in them receiving timely intervention from medical professionals. A relative said, “They (person) had an issue with their blood pressure, the staff identified it and sought medical advice and kept me informed all the way through”. Another relative shared, “Staff know their diagnosis unbelievably well; they do their upmost to support them”.

Consent to care and treatment Score: 3

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People were supported to make choices and have control over their lives.

Staff fully understood their duties regarding individuals who lacked capacity. By conducting robust capacity assessments and best interest decisions, staff maintained a strong person-centred focus. This approach guaranteed decisions were appropriate and closely aligned with personal preferences. One person told us, “I make all my own decisions. I do everything my way. The staff are compliant with my wishes; they listen to me. They have the time to talk to me”. A relative shared, “They have capacity to make their own decisions and staff respect that, they listen to them. They are all brilliant with them”.

Staff demonstrated a good understanding of the Mental Capacity Act and how to ensure people’s consent was gained. One staff member told us, “We knock the door, ask permission. Some say ‘no, not today’, so we would try again the next day. If they decline again, I pass it over to the staff allocated to certain people”. We observed staff seeking permission and offering choices with people before they commenced care tasks.