Mount Elton Nursing 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 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, well being and communication needs with them. A pre-assessment was conducted to ensure the service could meet peoples identified support needs. A health and social care professional said, “[The service] assesses people's needs well.” Staff we spoke with and observed supporting people demonstrated they knew people well. Care plans described how people communicated. For example, their preferred language and support aids such as glasses or hearing devices. A person said, “I’ve had new glasses recently.” Daily records documented the support people had received. This showed people were supported to bathe and assisted with their oral care. A person said, “They lower me into the bath, so I can soak in it. I use the bath chair. I can’t fault any of my 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. The service used nationally recognised tools to assess and monitor people’s needs and risks, including the risk of malnutrition and skin damage. People told us they enjoyed the food provided. A person said, “We get delicious food, and a choice.” Records showed people were given enough to eat and drink. People identified as requiring their fluid intake monitored, had daily targets in place. These were reviewed and if people had not had enough to drink this was escalated. Staff encouraged people to drink more where there was a risk of dehydration. A health professional said, “People have come to the home on end-of-life care, and the home has got people eating, increased people's fluid intake and their overall health has improved. Many people have lasted beyond what was expected.” Kitchen staff were informed and had access to information about people’s dietary needs and preferences. This included information about textured diets and any known allergies. Managers regularly reviewed people’s wounds, nutrition and hydration. Trends were identified and acted upon. For example, if a person lost weight the service monitored this, and it was reviewed by the GP with subsequent actions taken. A health and social care professional said, “Referrals are made, escalations are made.”

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 knew each other’s roles and responsibilities in managing and recording people’s health and well-being support. Information was shared and communicated effectively within the staff team to ensure staff knew of changes in people’s condition. This was completed through handovers, a diary and communication book. Information was shared with health professionals promptly. A health professional said, “The staff team have good teamwork, they pull together.”

The provider supported people to manage their health and well-being 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. Care plans gave information about people’s health conditions and what staff should be observant of. The service had oversight of people’s health and well-being, promptly referring people for additional advice and support when required. For example, if people had lost weight, the GP was informed, and people were supported with food supplements and a fortified diet.The service had positive relationships with the GP surgery and other health professionals. A staff member told us, “If someone is unwell, we request a visit from the GP surgery. We use the National Early Warning Score (NEWS) score to assess when we need to seek medical help.” NEWS is a tool used to standardise the process of recording, scoring and responding to changes in physiological status of acutely ill people. People were supported to attend healthcare appointments. Such as hospital and dental appointments. People with specific health needs were supported to have medical reviews by other health professionals.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves. People told us they were happy with the support they received. A person said, “It’s a lovely home, I’m very lucky to be here.” There was oversight of people’s needs. Records showed wounds and weight loss, for example, were monitored and analysed. People who had been assessed as being at risk of pressure sores had pressure relieving equipment set correctly. Referrals were made for people who required additional clinical support, such as the tissue viability nurse, occupational therapist and speech and language therapy (SALT). We observed armchair exercises taking place with people. Armchair exercises is a form of physical activity for anyone who has difficulty in exercising whilst standing and can help with posture, mobility, flexibility, balance and strength. A person said, “[Name of staff member] does exercises with me.”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Mental capacity assessment were conducted and associated best interest decision for living at the service. Assessments demonstrated information had been presented to people in ways that met their communication needs. Relevant people’s views were sought, such as family members, and they were involved in the decision-making process. However, no other specific areas of care and support where people potentially lacked capacity to consent had been assessed. For example, where bed rails were in use for people’s safety and where people were sharing rooms. 2 rooms were being shared with 2 people residing in each, who had not known each before living at the service. Some people were having their medicines administered covertly. This is when medicines are disguised in food or drink. There were no records of people being assessed for their mental capacity to consent to this. Although best interest decisions had been carried out and reviewed, the reviews did not include input from health professionals. The management team took immediate action to address shortfalls found in this area.

Staff listened to and respected people’s choices. We observed staff offering choices of where people wanted to spend time in the service and a range of drinks available. A staff member said, “People have choices, for example, what they wear.” We observed consent to care was sought by staff before support was delivered. For example, at mealtimes and when entering people’s rooms. A person said, “There is choice on the menu. I can choose my bedtimes.” Another person said, “I can get up and go to bed whenever I want.”