Elm Tree House

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 provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The provider carried out assessments before people moved into the service to ensure their needs could be met safely and effectively. People’s health, care, wellbeing and communication needs were regularly reviewed to reflect any changes in people’s circumstances or support needs. Where concern about a person’s health or wellbeing were identified, staff sought advice and support from relevant health care professionals. For example, when one person began to show possible early signs of dementia, staff made a referral to their GP for further assessment. This helped ensure the person received appropriate support and any changes in their needs were identified and responded to promptly.

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.

People had personalised plans to support their health and wellbeing. These included clear guidance for staff on how to meet specific health needs safely and consistently. For example, one person had an epilepsy care plan that had been developed with support from a specialist epilepsy nurse. The plan provided detailed information about the person’s condition, potential risks and the actions staff needed to take to support them and respond appropriately in the event of a seizure. This helped ensure the person received safe, effective and consistent care.

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 spoke positively about teamwork and described working closely together to meet people’s needs. During the inspection, we observed a handover between day and night staff. This included updates on how people had spent their day, any changes in their wellbeing, and important information such as when people had last received medicines prescribed on an ‘as required’ basis. This helped to ensure staff had the information they needed to provide consistent care.

The manager told us they worked closely with a range of healthcare professionals, including GPs, district nurses and speech and language therapists. This multidisciplinary approach helped to ensure people’s health needs were identified, monitored and supported effectively.

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 were supported to attend healthcare appointments when needed, and health professionals visited the home to provide advice and treatment where appropriate. This helped to ensure people’s health needs were monitored and addressed in a timely way.

Staff encouraged people to take part in activities that promoted their health and wellbeing. For example, one person told us they had successfully lost weight by making healthier food choices. Another person regularly attended swimming sessions to help maintain their physical health and wellbeing.

During our assessment, which took place during the heatwave, we observed staff encouraging people to stay cool and drink plenty of fluids. Additional support was provided by a manager from another service, who brought ice lollies for people to enjoy and help them keep hydrated.

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. Staff knew people well and monitored their wellbeing on a day-to-day basis. This enabled them to identify and respond promptly to any changes in people’s physical or mental health. People also received annual health reviews to help ensure their ongoing health needs were assessed and supported appropriately. Monitoring of people’s emotional wellbeing and mental health was effective. For example, we saw how staff had recognised when one person was feeling stressed and took appropriate action to provide support. Records showed the intervention had a positive impact and the person reported feeling better afterwards. This demonstrated how staff used monitoring and observation to respond to people’s needs and improve outcomes.

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

Mental capacity assessments were completed when needed and reviewed regularly. Records clearly documented areas where people had capacity to make decisions and where they required support. Where a person lacked capacity to make a specific decision, best interest decisions were made appropriately, involving relevant professionals, family members and advocates. Examples included decisions related to medicines management, the use of safety equipment and financial matters. Staff received training in the Mental Capacity Act 2005 and demonstrated an understanding of its principles in practice. During the visit, we observed staff supporting people to make their own choices. For example, during a visit to a pub, staff provided menus and offered support to help people choose their food and drinks, ensuring their preferences were respected and their decisions were their own. However, we identified one restrictive practice relating to the management of people’s snacks. The manager recognised this concern and took immediate action during the inspection to review the arrangements and complete the necessary best interest decision-making processes.