Coton 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 67 (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 registered manager told us they assess people’s needs based on individual requirements, they told us they used an electronic system to assess needs, risks and develop care plans to guide staff on how to meet people’s needs effectively. We saw care plans were regularly updated, and staff had knowledge of people’s needs and could describe how they supported people. The provider had systems in place to assess people’s needs and develop care plans, but these were not always effective. We saw assessments and care plans in place for people however, it was unclear who was monitoring people’s care plans to ensure they were completed and monitored. We spoke to staff who told us as part of their audit process they randomly selected a person’s care plans. However, we saw there was a process in place for other people that ensured people’s needs were assessed and considered before they started using the service. People and relatives told us they knew “vaguely” about care plans but there were no formal talks to discuss this.

The provider had systems and tools in place to support evidence-based practice. There were a range of risk assessments in place, including tools such as personal emergency evacuation plans and pain assessment tools. Staff were aware of these tools and used the available guidance to meet people’s needs. 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’s nutrition and hydration needs had been assessed and planned for. People and their relatives told us staff supported them to meet their nutrition and hydration needs.

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 told us they had systems in place to ensure people received coordinated and joined up care on admission. There was an electronic records system which held peoples care plans and enabled staff to record the care people had received. There was a handover process in place where important information and changes to people’s care needs could be shared with staff. The registered manager told us they had weekly ward rounds with health professionals, and we saw staff had engaged with a range of different health professionals to ensure people received support to meet their needs.

The provider’s systems did not always ensure people were supported to manage their health and wellbeing. The provider sought advice from health professionals about people’s health and this was documented in people’s care plans. However, staff were not consistently following the advice. For example, monitoring was not completed in line with professional advice for one person who had diabetes. Staff were also not consistently escalating concerns to health professionals when people experienced changes in their health. One person had not been referred to a health professional when their blood sugars increased and staff had not been following the advice to keep this person safe. However, people and their relatives felt supported to maintain and improve their health. A person told us, “When I had a fall, the medics were there immediately, and I am now under observation.” A relative told us about changes to a person’s needs since coming to the service and how this had improved their overall health and wellbeing.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they met both clinical expectations and people’s wishes. Reviews for care plans and risk assessments were completed monthly and when things changed. The registered managed told us a multi-disciplinary team (MDT) meeting approach was used to assess needs and also meet people’s changing needs which involved relevant health professionals and family. Staff were aware of changes and adjusted the care people needed accordingly. Staff gave us example where people’s health had improved since living at the service. For example, a person was assessed as requiring a hoist. However, after receiving care and support, she no longer required the use of a hoist and her health improved. The registered manager told us how one person who refused to eat or drink when she first moved to Coton House. Staff built a rapport with her to understand her needs better and gave her a opportunity to express what she liked and disliked. Staff were then able to better support the person with her diet in a healthy way. A relative told us “They have brought her a long way. She couldn’t walk when she came here, and they got her walking”.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People had their consent sought prior to receiving care and support. Staff told us they sought consent for example, when offering people their medicines. We saw where people were unsettled and refusing care interventions, staff supported people and reassured them. Staff stayed with people to provide them assurances and then delivered the care required with the person’s consent. Staff told us they had received training for the mental capacity act (MCA). Individual mental capacity assessments and best interest decisions were recorded and linked to people’s care plans. However, this was not consistent. For example, people had not signed consent forms or had their capacity assessed for some areas of their care, including the use of CCTV, bed rails and sensor mats. The provider said this was an oversight and they would ensure the documentation was updated to consider these areas.