Robert Harvey 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 inspection we rated this key question outstanding. 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.

Assessments were undertaken before people arrived at the home to ensure all needs could be met. Electronic care planning was robust and person-centred. Records were updated when people’s needs or preferences changed. Staff demonstrated a good understanding of people’s assessed needs and spoke positively of the communication methods within the home, particularly highlighting the support and communication with the registered and deputy managers.

Healthcare professionals told us that people’s well-being was very good with the staff team knowing the people they supported and cared for very well. They also felt that communication was effective due to a close working relationship within the whole team and not just the care staff.

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.

Care records were person-centred and detailed. Family and health and social care professionals shared information that aided in the development of the plans when people were unable to share information themselves. Records showed people were being cared for in line with their assessed needs.

Staff told us that there was ‘plenty’ of family involvement and as a service this was encouraged.

A relative told us, "They do tell you if there’s any medicines changes, so we never have to contact the doctor for information.” They went on to say, “[Person] has regular reviews with the doctor which they always feed back to us on.” Another said, “They ring us straight away if there’s a problem and they always get the doctor quickly.”

The catering team was well established, and we met with 2 of the regular cooks who were extremely enthusiastic about the provider’s generosity and support. The described how they could provide a quality menu where individual preferences and treats could always be accommodated. One told us, “It’s a fantastic company to work for and we want for nothing."

We saw, where appropriate, people had regular input from visiting health care professionals such as district nursing team. Staff told us they had updates about people’s health and support needs through team meetings, supervision and/or spot checks.

Everyone we spoke with told us the provider and their staff delivered good care and support to them.

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 regularly reviewed people’s needs and kept their information up to date. Hospital passports, and do not attempt cardiopulmonary resuscitation (DNACPR) documents were in place and up to date. These documents gave hospital staff instructions on how to best support people and their wishes.

The registered manager and deputy formed an extremely effective working relationship and together had fostered a strong team ethos and supportive culture within the home. They were visible, involved and present in the home. We observed staff working well as a team, particularly during mealtimes and during activities arranged by the activity coordinators.

The provider had senior care staff to provide extra support, guidance and expertise to the home’s management and care staff teams. Senior care staff strengthened governance through regular oversight, supported the management team, and provided ongoing guidance. This contributed to improved oversight across the service and also helped to support audit activity within clinical, housekeeping and maintenance.

Flash meetings were a daily feature where all heads of department came together to share relevant information, review new admissions or anyone whose condition had changed. Relevant staff updates were also covered. We saw relevant notes of what was covered and agreed each day.

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.

People accessed healthcare services in ways that suited their individual needs. Some attended appointments at GP surgeries and dental practices, while for others, healthcare professionals visited the home. This flexible approach ensured that people received timely and appropriate care. There were close links with the local GP practice and regular visits from surgery staff were arranged. Staff knew they could (and did) contact the surgery for appointments or guidance on how best to support people as and when required.

People told us they were supported to access routine health services to enhance their health and were supported and encouraged to maintain mobility and join in with exercise activities.

One person told us, “The desserts provided are very good and the diabetic portions do help me. I am usually offered a diabetic choice, which does help and does not make me feel as guilty when eating fruit.”

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.

Following a stroke, 1 person became permanently bed-bound with significant rigidity and had become increasingly isolated from the life of the home. The staff worked closely with physiotherapists; staff developed a personalised programme of exercises which they incorporated into the person’s daily routine. Staff remained committed to the person’s goals, consistently encouraging them by talking about the activities they enjoyed and wanted to regain.

Through this collaborative approach, the person was eventually able to sit comfortably in a tilt-in-space chair. This transformed their daily life and once again they were able to share meals with other people living at the home, participate in activities, spend time outdoors and maintain meaningful social relationships. Staff and relatives saw a significant improvement in the person’s mood, confidence and overall well-being, which had a profound impact on the person’s quality of life. This evidenced the provider’s commitment to ensuring people lived fulfilling lives rather than simply receiving care.

Care records were reviewed regularly and amended appropriately. Individual care plans were clear and person-centred which enabled staff to provide the right care to people. Where people were prescribed time-specific medicines, clear procedures were in place to ensure staff administered these at the scheduled times to ensure people received the correct and appropriate care. For example, there was information about a person’s symptoms from constipation. The care plan described what they were prescribed and why. It also stated when and how staff should administer the medicines and in which order.

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

Care plans considered people’s capacity and their ability to consent to their care and make decisions about the support needed. This meant the service worked within the principles of the Mental Capacity Act 2005 (MCA). Staff had completed their mental capacity training, and those spoken with gave examples of how they understood the importance of gaining consent from people and encouraging people to make their own decisions about their care and support. One staff member told us, “Some of the clients do have the capacity to make their own choices but others do not always have capacity to make choices, but we will always get consent first. I ask them are they ok for me to do their personal care. If they do not want me to, I would go and do something else and try again later.” There was guidance for staff within people’s care plans about how consent might look for people, where they might lack mental capacity.

People and their family members felt their views and wishes had been considered when care and support was being planned. People told us staff always sought their consent before delivering care. Family members told us they were very much involved in supporting people with making decisions about their care where appropriate.

Appropriate best interests’ decisions had been taken where people were unable to make decisions for themselves. Deprivation of Liberty Safeguards (DoLS) applications had been submitted to the local authority for authorisation, in line with legal requirements. In health and social care, it is a legal process used in England and Wales to protect adults who live in a care home or hospital and cannot make decisions about their own care.