Little Manor Care Centre

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 83 (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 were admitted to the service from a hospital setting. Information about people was provided to the service prior to admission and on arrival. This included discharge records from the hospital outlining people’s current needs. There was an expectation that people who were at the service were on a programme of rehabilitation with the aim to return home or to another care setting.

Staff told us the care plans were developed as staff got to know people and learn about any specific needs or preferences they had. Care plans recorded details on the immediate rehabilitation needs of people and any other specific health care need they might have.

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 care and treatment was planned in line with best practise and nationally recognised assessment tools and guidance. For example, staff used the nationally recognised tools for areas such as assessing risk of pressure damage and malnutrition. We also observed there was guidance for staff on IDDSI levels (International Dysphagia Diet Standardisation Initiative). This guidance helps staff to know what food and fluid people need when they are at risk of choking.

There was an MDT team involved in people’s care, where best practise was shared. There was good oversight of people’s needs because weekly MDT meetings took place. The outcome of these meetings was recorded in people’s care plans which meant all staff involved in people’s care could read this.

Leaders said they kept up to date with any changes to practice or legislation in a variety of ways. Nursing staff had regular updates from the Royal College of Nursing and were able to join training events. Any learning was cascaded to other staff.

People’s needs for nutrition and hydration were recorded in their care plan. People could choose where they wanted to eat. People said the food was good. Comments from people included, “The food is fine, and I have snacks and drinks provided when I want them” and “I have no worries or concerns about the food.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

A range of health professionals were involved in people’s care, including the onsite rehabilitation team of physiotherapists and occupational therapists, and the social care team. Staff worked consistently well together to share information and plan care to make sure people’s needs were met. They told us they had easy access to care plans, which helped them provide consistent and effective support. One healthcare professional said, “Staff I have worked with present professionally and work effectively alongside the therapy team, following care plans and clinical advice appropriately.”

Staff said communication across the teams was consistently good and that information about people’s needs was shared promptly. Comments from the staff included, “Handover is daily on every shift, we go through each patient. If there are any concerns we can pitch in, each staff member is involved” and “Our team is very good. We need to be able to communicate to make sure people have the rehabilitation they need. We are communicating for the wellbeing of the people here.”

Professionals shared feedback that communication amongst all the staff was consistent. One health professional said, “We know all of the day staff really well. We communicate with them well, and we have a good working relationship. We know we can ask them to move people in a specific way and that they will follow the plan. We make sure we put all the information and equipment in place. If people need a bit more rehab at weekends, the staff will also do that.” Another healthcare professional told us, “I believe that Little Manor has strong foundations in communication and leadership with a patient-centred practice and multidisciplinary team approach.”

There was a weekly MDT meeting where every person was reviewed. This enabled planning for discharge to be discussed so additional services could be sourced. For example, if people needed care at home, or additional equipment. These services were planned and set up for people prior to their discharge from this service. This enabled people to have a continuity in their care as teams were working well together to co-ordinate support.

People were complimentary about all of the staff teams working at this service and appreciated their approach. People knew what their goals were and shared examples of how their outcomes were improving. One person said, “All staff have established a good rapport with me which helps me feel settled. I know what is happening with my recovery.” Another person told us, “I have been here about a month and have received excellent care. I am really getting back on my feet now.”

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.

Staff monitored people’s health consistently. For example, when required, people with diabetes had their blood sugars monitored. The aim of the service was to promote and support people to rehabilitate, which in turn would support them to live healthier lives.

The service organised exercise classes for people in addition to their planned rehabilitation. Posters were around the service advertising dates and times for people.

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

Systems and processes were extremely effective in monitoring people’s care outcomes and supporting ongoing improvement. Data on people’s admissions and discharges was monitored to make sure placements met the 5-week goal. People’s individual needs, care and rehabilitation was discussed every week within the MDT meeting. This enabled the whole team to review and make timely changes when people’s needs changed. The partnership working and collaborative approach at the service had been very successful in supporting people to get back on their feet and move home.

There was good and consistent oversight of people’s needs by all teams involved in people’s care. Records showed that mobility, wounds, and weight loss for example were monitored and analysed. Staff worked closely with other professionals on site to improve outcomes for people. One health professional told us, “[Provider] developed an ‘Intensive Rehab booklet’ which is given to patients. This helps to set patient's expectations on arrival. Our outcomes are generally good here.”

The provider shared examples of people’s successful rehabilitation. For example, 1 person had been admitted from hospital unable to mobilise and needing a hoist to transfer. After a period of rehabilitation and confidence building, this person moved back home independently mobile with a walking frame. For another person, staff had contributed to improving their mobility but also supported the person to make a social connection with another person. This person moved back home with increased motivation and an improved outlook having made a friend who lived near them. Staff working collaboratively with partners to make sure people’s stay was both a positive experience and had successful outcomes. People being able to return to their homes was a core aim.

People told us they could see improvement with their skills which was because of the excellent care and support they received. Comments from people included, “I have excellent care which is greatly increasing my independence, and I am hopeful I will soon be going home, safely and ready” and “I am now independent using the shower, thanks to staff and professionals help here. This is great for me preparing to move home.”

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

Consent to care was sought in line with legislation. Records showed people had consented to all aspects of their care and rehabilitation. Assessments for mental capacity were completed when people moved into the service. During this assessment everyone using the service had capacity to make their own decisions.

Leaders were knowledgeable about the principles of the Mental Capacity Act 2005 and had systems to ensure if people lacked capacity, decisions would be made in people’s best interest.

We saw that staff routinely knocked on people’s bedroom doors and asked their permission before entering. We saw staff support one person into the dining room, and they asked the person, “Where would you like to sit?” and “What can I get you to drink?”