Archived: Gardens Neurological 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 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 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.

Detailed assessments were completed before people moved to the service. However, we received mixed feedback from relatives as to their level of involvement. One relative told us, “We were involved in the referral process, the home provided us with a care and support plan, we’ve also been invited to attend assessment sessions e.g. speech and language, these were very positive”. Another relative told us, “I wasn’t really involved in the referral or admission process, this was managed by [Name of hospital]. We didn’t receive a welcome pack, and there were no introductions to staff.”

The provider had recently completed a review of their admissions process. We shared the feedback from relatives, and they confirmed they would conduct a review of communication at all stages of people’s care and ensure that information was shared where appropriate, and in accordance with people’s wishes.

People’s needs were consistently reviewed. We saw that care plans were detailed, personalised and up to date. Recognised tools were used to assess people’s level of risk in relation to aspects of their health such as Waterlow, for skin integrity, and MUST, for nutrition.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Detailed assessments were completed before people moved to the service. However, we received mixed feedback from relatives as to their level of involvement. One relative told us, “We were involved in the referral process, the home provided us with a care and support plan, we’ve also been invited to attend assessment sessions e.g. speech and language, these were very positive”. Another relative told us, “I wasn’t really involved in the referral or admission process, this was managed by [Name of hospital]. We didn’t receive a welcome pack, and there were no introductions to staff.”

The provider had recently completed a review of their admissions process. We shared the feedback from relatives, and they confirmed they would conduct a review of communication at all stages of people’s care and ensure that information was shared where appropriate, and in accordance with people’s wishes.

People’s needs were consistently reviewed. We saw that care plans were detailed, personalised and up to date. Recognised tools were used to assess people’s level of risk in relation to aspects of their health such as Waterlow, for skin integrity, and MUST, for nutrition.

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.

People benefited from having a range of in-house services along with external health services such as the GP. One person told us, “I am supported with physio, speech and language and the occupational therapist (OT). Everyone knows what I need.” A relative told us, “Yes, different parts of the service work well together and we’re informed about expected outcomes.”

We saw that advice, guidance and direction from all partners was included in the records we reviewed.

Some staff told us they felt there was a disconnection between teams at the service. One member of staff told us, “The [clinicians] do not help out on the floor at all. There is a divide between [clinicians] and carers.” We shared this feedback with the provider who confirmed they had identified this concern and were working with teams to encourage joint working and cohesion amongst staff. It was clear from the feedback we received that the closure of the first floor of the service and pending changes in staffing structures had contributed to feelings of instability amongst staff.

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 had access to a wide range of health services. A relative told us, “Yes, [relative is] definitely being supported to improve [their] health since moving in.”

Staff knew how to monitor and respond to any changes in people’s health.

People were encouraged to be involved in their care as much as they were able and wanted to. People spoke positively about the therapeutic activities available to them which staff encouraged them to join. One person told us, “I have been here [length of time]. The best time I have had. There are activities, doing sensory things, we go out. The activity team is excellent, something every day to do. (They are) not here on weekends but we have a weekend box.” They went on to explain that the ‘weekend box’ was a range of activities that could be accessed by anyone to use, when activity team members were unavailable.

Regular meetings and handovers were held amongst all staff members to share information and enable oversight of people’s health and wellbeing.

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.

People’s plans of care were routinely reviewed, with positive outcomes shared with us by both people and their relatives. One person told us, “I had a [medical device] and because of the physio I am now on [a modified diet].” A relative told us, “[Relative’s] quality of life has improved. [Their] wound (acquired in hospital) was healed, and progress is being made to get to [relative] eating again and removing the [medical device].”

Records detailed people’s planned outcomes, including both short term and longer-term goals. The provider confirmed that this was an area of care planning they wished to develop further with the newly recruited manager once they commenced their role.

There were systems in place to have an overview of clinical risks for people such as wound management, nutrition, infections and hospital admissions.

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

Processes were in place to enable people to make their own choices. Staff knew and understood people’s communication needs and adapted their approach when needed.

Where people were unable to communicate their own wishes, or give consent, a collaborative best interest’s process was undertaken with all relevant stakeholders. A relative told us, “I feel all of our wishes are taken into account, consent is sought for everything.”

People’s care plans included capacity assessments which detailed how their capacity for the decision was assessed. Where needed, best interest decisions were made, and also Deprivation of Liberty Safeguards (DoLS) were requested or in place.

We noted that a number of best interests documents had been completed for people who were assessed as having capacity. Whilst we saw these records confirmed capacity, and no decision was reached on people’s behalf, these records were unnecessary. The provider confirmed they were making ongoing checks and reviews of documentation in place.