Hollyfields

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.
Information was gathered about people’s likes, dislikes, preference, risks, and communication requirements before they moved into the service. Regular reviews of people’s assessed needs were being completed. Most people we spoke with felt they were involved with how their care was planned, and felt staff knew their needs and preferences. A relative told us, “I think the home communicates well with me, I always feel involved with my husband’s care”.
 

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 assessed people’s nutrition and hydration needs. Some people required special diets due to the risk of choking. Staff followed nationally recognised guidance to prepare meals to the correct consistency to reduce the risk of choking. People’s weight was monitored and action taken where people were experiencing unintentional weight loss. People told us the food was good. Comments included, “The food is good and there is always a choice” and “The meals are alright, there are a couple of choices of mains, I can’t complain”.

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. Systems were in place to enable effective communication. For example, handovers between shifts and daily meetings to discuss any changes or concerns in people’s needs and any activity for the day. Staff worked with health partners who visited the service regularly to monitor and support people’s health needs.

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. People described how they accessed a variety of health care professionals and were supported by staff to achieve this. One person told us, “I see my doctor if needed, he visits on a Monday and I can ask to be seen, the optician also visits here”. Staff arranged visits from health care professionals such as the optician and chiropodist when needed. They supported people to be as involved as they wished and were able, in managing their own health appointments. People were able to attend different keep fit activities arranged by the activities team.

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. The provider used an electronic care record system and set up alerts to monitor key health indicators such as fluid intake and weight. The alerts helped staff respond promptly to changes in people’s needs. The registered manager had oversight and visibility of care delivery, enabling them to track compliance and intervene when necessary. We observed monitoring records and found these were mostly compliant with instructions in care records. Monthly clinical meetings were held to discuss people’s needs and any changes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. We reviewed whether the service was operating in line with the principles of the Mental Capacity Act 2005 (MCA), including the use of appropriate legal authorisations for any deprivation of liberty Safeguards (DoLS). DoLS are legal proceedings to protect people who lack capacity to consent to their care and treatment. We found the service had not consistently identified all restrictions in place for some people, and corresponding records were missing. Mental capacity assessments did not always have a corresponding best interest decision record. Where best interest decisions were recorded, some lacked detail. For example, some people had monitoring arrangements in place to help maintain their safety, this had not been identified as a restriction and had therefore not been considered in line with the principles of the MCA.”
We discussed our findings with the provider who acknowledge work was needed in this area, and following our site visit confirmed documentation relating to MCA and DoLS had been reviewed. People told us staff sought their consent prior to providing any support. Care plans included people’s ability to consent and make decisions.