Handford House Care 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 good, and people’s feedback confirmed this.

At our last assessment we found a breach relating to consent, at this assessment we found the provider was no longer in breach of the regulation. These improvements needed to be embedded and sustained in practice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s needs were being assessed and they were supported to access other services, such as health care services, where required. People were supported to maintain healthy lives and their dietary and hydration needs were being assessed.

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.

People’s needs were assessed prior to them using the service, this included consultation with the person, their representatives and other professionals involved in their care. Where a person was admitted into the service in an emergency, the needs assessment was undertaken as soon as possible. The needs assessments were used to inform the person’s care plans and risk assessments, which were kept under review. Since our last assessment improvements had been made in how the care plans and risk assessments were reviewed, which included consultation with the person and their representatives, where appropriate. This included comments made by the person about how they felt their needs were being met and if there were any changes identified.

People’s care records included how they communicated and any specific support they required with their communication needs and how this was met.

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.

Since our last assessment, the provider had introduced the ‘resident of the day’ system. This included speaking with the person about their views of the service they received, if their needs were being met and any changes they required. People’s relatives, where appropriate, had been contacted and invited to review their family member’s care, and how often they wanted to be involved in the process, for example, monthly, annually, or quarterly.

The provider’s policies and procedures included reference to industry recognised good practice guidelines including National Institute for Health and Care Excellence (NICE). The provider kept up to date with changes in legislation and good practice, and these were incorporated into policies and procedures and training.

People’s needs and risks were assessed in relation to nutrition and hydration. This included risks of malnutrition, people’s weights were being monitored and any concerns were referred to, for example a dietician. Guidance was documented and followed and people’s dietary intake was recorded and monitored. This included the provision of a fortified diet and high calorie snacks and drinks, such as milkshakes, to help reach and/or maintain a healthy weight. Catering staff told us they were kept up to date on people’s specific needs to ensure they received a suitable and safe diet, including diabetes, allergies and consistency.

People’s care plans included a recommended fluid intake for each day, people’s drinks were recorded and were monitored daily. If low intake was noted by staff, further encouragement was provided to drink. Drinks were accessible to people and offered by staff.

We received mixed feedback about the quality of the food provided. Records and discussions with the management team showed people were consulted about the menu and where required it was reviewed to meet people’s preferences. In addition, people could choose an alternative from the menu choice if required. We saw people had access to snacks, this included fresh fruit where people chose a healthier option than the cakes and biscuits also on offer. Care plans included people’s likes and dislikes.

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.

Since our last assessment, improvements had been made in how people’s needs were documented in care plans and guidance provided to staff in how they were being met. Staff had access to information about how to meet people’s specific needs.

The provider worked with other professionals involved in people’s care, where treatment or guidance had been received, this was incorporated into care plans to ensure consistency and joined up care. Information was shared across teams involved in people’s care which also maintained consistency, such as if a person required hospital admission.

We received feedback from social care professionals to show the provider had worked with them to make improvements in the service, since our last assessment.

Staff attended handover meetings at the start of their shift where they received information about people’s wellbeing from the previous shift, and any actions required. We observed a staff handover which demonstrated people’s wellbeing was being monitored and important information shared between teams.

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 told us they had access to health professionals when needed, such as staff from the GP surgery. The manager told us how they had met with the GP and had ongoing communication with them to ensure people received the service they required and to ensure both services understood referrals and treatment options.

Where staff had concerns about people’s wellbeing, referrals were made to other professionals and guidance and treatment was documented and guidance incorporated into the care provided, including people’s dietary needs. People were consulted about the care provided, including their health needs and how they were met.

The provider routinely monitored people’s care and treatment to improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People’s care was routinely monitored and assessed, with consultation with people and their representatives, where appropriate. Improvements had been made in people’s care plans, which now reflected people’s specific needs, how they impacted on people and how their needs were being met. The care plans were kept under review to ensure any changing needs or preferences were reflected in the plan of care and staff were kept up to date with people’s current needs. Concerns about people’s wellbeing were identified and referrals made, where required, to other professionals, including health care professionals. For example, where a person was at risk of pressure ulcers developing, regular monitoring was being undertaken to ensure any deterioration to the skin was identified and actions taken to reduce risks, such as repositioning.

Since our last assessment, improvements had been made which needed to be embedded and sustained in practice. The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS)

We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

People’s care plans included information about their capacity to make decisions and if a DoLS was in place. Capacity assessments were in place relating to the care provided, such as if they could consent to living in the care service and medicines. Where people required support with decisions in their best interest this was documented including the people responsible for making these decisions, such as a lasting power of attorney. Where people were appointed to make decisions on people’s behalf, in areas including health and welfare and/or finance, care plans demonstrated documents were kept on file to reduce the risks of unappointed people making decisions.

DoLS applications were made where required. A tracking document was in place which showed where the DoLS had been granted with or without conditions. The dates of the DoLS were included, which showed when they required reviewing.

During our visits to the service, we observed staff asking for people’s consent before providing any support. Staff had received training in MCA and DoLS and in the staff room area there was information about the five principles of the MCA.