Sholden Hall Residential 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 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.At our last assessment, we found people’s care plans had not always been developed with them or had not always been reviewed to make sure they were up-to-date and accurate. At this assessment improvements had been made. People’s care plans had been reviewed and re-written to include detailed information about their choices and preferences. There was clear detailed information to assist staff to support people in the way they preferred. People and their relatives had been involved in updating the plans. The manager told us, they had introduced a keyworker system, staff had been given time to speak to people and their families to make sure the care plans were accurate.

Staff had completed recognised tools to understand people’s needs such as promoting skin integrity and preventing unintended weight loss. Staff knew people well, we observed staff supporting people following their care plan. A relative told us, “The male staff are doing a very good job; they shave him and cut his hair. I could not do that – he would just push me away”.

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. At our last assessment, staff had not always followed the guidance from healthcare professionals or delivered care in line with what was important to people.

At this assessment there had been improvements. When required staff had monitored people’s daily welfare including fluid intake and blood sugar levels. There was clear guidance for staff about when to record people’s blood sugar, this had been documented, the person’s blood sugar had been stable. Previously, people told us they did not always receive their food preferences. During our onsite assessment, we observed people having the food of their choice in the way they preferred. People commented on how much they had enjoyed their lunch.

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. At our last assessment, we found staff had not always followed health professional guidance or contacted them when people’s needs changed. At this assessment, some people who had specific needs around anxiety and supervision to keep them safe, had left the service. Staff had worked with health professionals to assess their needs and move them to a more suitable setting when the service had been unable to meet their needs.

Staff told us they worked well as a team and were knowledgeable about people’s needs including supporting people living with diabetes. Staff confirmed they had regular handovers and were involved when health professionals visited people to make sure they understood the guidance given.

The provider supported people to manage their health and wellbeing, so people could maximise their independence, choice and control. Staff supported people to live healthier lives, or where possible, reduce their future needs for care and support. At our last assessment, people and relatives told us there was not always activities they enjoyed available to them. The manager told us they had started to make improvements to the range available but there was still work to do.

People and relatives were positive about activities and the effect on people’s wellbeing. A relative told us, “(Relative) is agoraphobic and, in the beginning, they left them alone and didn’t force them to do anything but now they join in and has really come out of themself”. Another relative told us, “They have a lady and a couple of volunteers go in and organise games to keep them alert and keep their bodies moving. They have a chap who goes in and sings, and someone goes in to do her nails and a hairdresser”. We observed staff, volunteers and people enjoying activities together.

Relatives confirmed staff had contacted health professionals when their family members had become unwell. Staff told us they worked with the district nurses to make sure people had investigations such as blood tests when needed.

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. At our last assessment, people’s care and outcomes had not always been monitored as records had not been accurate, for example, people’s fluid intake.

At this assessment, there had been improvements. People’s records had improved, staff were recording, when required, people’s fluid intake, blood sugars and change in position. The manager had clear oversight of people’s care. When people’s care plans were reviewed staff used the information from people’s care records to check the outcomes were being met. For example, if people’s blood sugars were within the required range.

The manager and staff continued to support people to achieve their goals including aiming to go back home. People were supported to go on weekend or day leave with family to support this aim.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. At our last assessment, people told us they were not always asked for their consent before they were supported, and their choices were not always respected.

At this assessment, improvements had been made to the assessments of people’s capacity and best interest decisions had been made with reference to people’s choices and preferences. Staff had incorporated these preferences into people’s care plans, with detailed guidance about how people wanted to be supported, including to maintain relationships.

We observed people being asked how they wanted to spend their time and what they would like to eat. When people had declined an offer from staff this had been respected and staff had waited until they were ready. A relative commented, “They have got free range to do what they want; they can go upstairs for a nap and walk round the garden”.