Hunters Care Centre

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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People had their needs assessed before moving to the service. Staff told us this was carried out face to face in order to ensure the service was able to meet people’s needs.

People’s needs were regularly reviewed. People told us staff discussed their support needs as part of the “Resident of the day” system. Through this system, people had input from all departments in the service on that day each month to oversee areas such as care and support, environment safety, cleanliness and food.

One person said, “I know when resident of the day is. The staff come and weigh me, check my blood pressure etc and have a chat about how things are.”

Another person told us, “After having a fracture and returning to Hunters from hospital, my care needs have changed. The care which I receive from them is excellent, the staff are all caring. The staff do encourage me to face new challenges in a safe way.”

Relatives confirmed that they were involved in discussion about their loved one’s care and support.

One relative told us, “We are involved in decisions relating to our relative’s care and have seen and discussed the care plan.”

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.

Nationally recognised clinical tools were used to assess the risk of skin damage, falls and malnutrition. People’s weight was monitored and reviewed monthly to ensure oversight at management level. However, some of the fluid intake charts we looked at did not always show people were provided with enough to drink. For example, the records for one person showed a total fluid intake for one day of 200mls. Additionally, it was documented in the person’s care records for that day, “Good food and fluid intake.” In another person’s care plan, it was recorded that the daily fluid target was 1500mls, but records we reviewed showed this target had not been met for the previous 7 days. Staff had also documented “No concerns” in relation to food and fluid intake.

We fed this back to the registered manager who told us they would discuss this with staff and would review how fluid intake was monitored. The registered manager showed us minutes of a meeting held with staff between our onsite visits, to discuss fluid monitoring checks. On day 3 of the inspection, we saw records which showed people had enough to drink.

We looked at care plans for people who had wounds. Wound plans gave clear instructions for staff, regular photographs of wounds had been taken and measuring tools were in use. Wounds were reviewed at clinical meetings and there was evidence of management oversight to monitor if wounds were improving or deteriorating.

Records showed concerns about weight loss were escalated to the GP. Nutritional care plans were in place and detailed any dietary requirements alongside people’s preferences for what they liked to eat and drink.

When people needed staff support with eating and drinking or when adapted cutlery or utensils were required, this was documented.

People gave mixed feedback about the food, but also told us that when they had raised concerns, these had been addressed. For example, one person told us they didn’t think the curry on the menu was spicy enough and some other people had agreed. When they had raised this with the chef, the chef had made a spicier version of the curry for this group of people.

The chef told us that a monthly meeting was being held to discuss the menu with people. They told us people’s relatives were also welcomed to attend the meeting, and this was advertised on the weekly activities’ planner. For example, they told us that at the last meeting which was held the previous day, 28 people and 2 relatives were present, and feedback was sought in relation to the recent change of supplier. The menu was also discussed with people individually during the monthly “Resident of the day system”. The chef provided an example of when, on this specific day, they made fillet steak for one person who asked for this.

We observed people being supported at lunchtime. People could choose where they wanted to eat. Some people were supported to eat in their rooms while others were having their meal in the dining areas. We observed staff giving people choices of what they would like to eat, for example by presenting show plates with the menu options. One person told us, “The care at mealtimes I am impressed by, no necessary to me but to everyone.”

The service 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.

The service was supported by members of the multi-disciplinary team from the local GP surgeries. Health professionals we spoke with told us the staff were proactive in making contact for advice and followed any recommendations. One health professional said, “The team are really good at giving us the information we need before we visit. They are very proactive; we give them our contact details and if it can wait until we visit that’s great, or they will make contact and ask us to come sooner. The communication between us and them is very good.”

Another healthcare professional working with the service told us, “They would contact pharmacy team at our surgery through phone/email to confirm if there is change in medication(s) / issue with prescription.They aim to have medication review every 6 monthly. If they have new resident or resident discharged from hospital, they are efficient to provide the necessary document(s) needed for medication reconciliation.” and another said, “Communication and our relationship with the team members is great. If were request information – they send it promptly.”

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

People told us staff contacted the GP for advice if they were unwell and supported them to attend healthcare appointments.

One person said, “The doctor came today to see me about my [condition]. [Staff member name] is very kind, and she suggested the doctor came and checked on me.” People told us staff supported them to attend healthcare appointments if needed.

One healthcare professional told us, “Another example of their proactive and forward-thinking approach is a project currently being planned, the development of a Physio or “Gym” corner in one of the communal rooms. This will provide residents who are able to take part in more active rehab with access to appropriate equipment and a dedicated space to support their mobility and independence.”

The service 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.

There was oversight of people’s needs in place. For example, a daily meeting was held and documented, attended by department heads. We attended this meeting and observed staff review any incidents that had occurred overnight, the clinical status of people and anything else for staff to be aware of.

We saw records which showed that wounds, weight loss and falls were monitored and analysed. We saw that referrals had been made for people who required additional clinical support, such as the local hospice, the mental health team and speech and language therapy (SALT). There were regular reviews by a health professional from the local GP surgeries.

A healthcare professional shared with us an example of successful joined-up care which led to improving outcomes for one person, “Another example of successful, joined-up care involved a long-term resident who arrived as a full hoist transfer following a stroke, with dense left-sided weakness and inattention. A little over a year later, with consistent support from staff, family, and therapeutic input, this resident now walks independently with a four-wheeled walker, which has improved her quality of life immeasurably.”

Another healthcare professional told us, “The needs of the residents are closely monitored and assessed.”

One person told us they used to use walker to aid their mobility, but now they only need to use a walking stick. Another person said, “I came for respite care to get better after being in hospital following a stroke, this is the place where you need to be if you want to get better. Now, I am looking forward to go home as I feel stronger.”

One relative told us, “They [staff] are very responsive to any changes in my [relative] as they know her well.”

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

In the main, mental capacity assessments had been carried out in line with legislation and records relating to best interest decisions detailed how decisions had been reached and included details of any less restrictive options considered. Although we noted one person with a sensor in use and no reference to this was documented within a mental capacity assessment and best interest records, this was rectified when we fed this back to the registered manager.

People told us and we observed that staff consistently knocked on bedroom doors before entering. One person said, “They [staff] always knock the door, even when it’s open.” People told us staff always asked for their consent prior to supporting them. Throughout the inspection we heard staff saying things such as, “Hello [name]. Can I help you with that?” and “Would you like me to walk with you?”