Admiral Jellicoe House Also known as The Royal Naval Benevolent Trust

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 63 (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 did not always make sure people’s care and treatment were effective.

We reviewed people’s care plan and daily notes. One person’s care plan stated they were to complete small exercises 10 times a day to help manage a health condition. We reviewed this person’s daily notes and found no evidence they were being supported to complete these exercises. Two people’s care plans stated they were to be repositioned at 4-hourly intervals as they were at risk of developing pressure wounds. The daily notes we reviewed for these people evidenced this was not taking place . We also found this concern at our previous inspection.

We spoke with the registered manager about this who told us they would be reviewing everyone’s care plans and ensuring the support required was correct. They had also added additional daily checks to ensure this support was given. They told us they would complete spot checks to ensure this was consistently completed.

Staff told us people’s views were sought by using their preferred communication methods across various platforms including, during daily support and in meetings.

People were involved in their assessments and reviews. Staff and/or those who knew people well were involved in people’s assessments to ensure their views and opinions were captured.

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.

Staff monitored people’s weight and used nationally recognised tools appropriately to assess and monitor people’s needs. For example, the Malnutrition Universal Screening Tool (MUST) was used to identify people at risk of malnutrition. Recognise Early Soft signs, Take Observations, Respond and Escalate (RESTORE) was used to identify when people’s health was deteriorating. We reviewed people’s daily notes and when a person became unwell, we noted the provider used these tools and sought medical advice and support as a result of this. The provider continued to monitor this person using the tools on a daily basis until they had made a full recovery.

Staff ensured people had enough to eat and where there was a concern in this area, staff had completed a referral to the relevant health professional requesting additional support.

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.

The provider had processes in place to ensure care and support was coordinated in the best interests of people using the service which included collaboration with professionals and information sharing.

We sought feedback from professional’s who worked closely with the service. One professional told us, “The staff, in particular the senior staff nurse are good at contacting us when residents arrive that have Parkinson’s disease. We then meet to assess the patient and work together risk assessing and care planning to meet the individual needs of that patient. The staff are excellent at following the care plans, taking the time people with Parkinson’s need when assisting them and they ensure they get their medication on time.”

The provider mostly 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.

Care records mostly captured the support people required with their health needs and what action staff should take when there was any deterioration to an individual’s health.

We spoke with relatives, 1 relative told us, “The home has prolonged my relative’s life. They are given their medication on time. Staff look after them. A sensor mat is in place if my relative falls and they carry out 24 hour observations following falls. Staff will take them to see the GP when needed and I will get a follow up phone call to update me.” Another relative told us, “They encourage my relative to walk around. My relative is quite active. They encourage them to take part in fitness classes. They encourage them to come out of their room. They check on them.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People were engaged to ensure they were able to make some choices about their lives. Individual meetings took place with people to understand their goals and aspirations. However, these had not always been effective in ensuring people’s prescribed daily exercises were completed and they were repositioned as recommended, which meant the provider did not always ensure people had positive health and wellbeing outcomes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

We reviewed mental capacity assessments (MCAs) and best interest decisions (BI) which were not always completed in line with the Mental Capacity Act 2005. For some decisions these were not in place, for example for 1 person who was declining medicines, where there was a concern of fluctuating capacity. Where they were in place we could see how the person had been involved in the assessment and how the provider had attempted to support the person to understand the decision, however, not all decisions detailed how people’s relatives had been meaningfully involved. We also found this concern at our previous inspection.

The registered manager told us, they would commence work on the MCAs to ensure they were completed in line with Mental Capacity Act 2005 and were in place for all important decisions.

A DoLS tracker was in place to ensure the provider knew when these needed to be reapplied for.

Staff described to us how they sought consent throughout the day-to-day tasks they supported people with.