Archived: Hilbre 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.

This is the first assessment since this service was registered. This key question has been rated 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, well-being and communication needs with them.

People’s needs had been assessed prior to their admission to the service. The provider utilised an ‘All about me’ document which recorded people’s current needs and history, enabling people to be cared for in line with their choice and preference.

Where people had specific health care needs which required regular monitoring, such as nutritional and skin integrity needs, assessment tools were used to help assess people’s level of need, to help ensure people received the correct level of support which was appropriate for them.   

Staff worked in 12-hour shifts and had a handover when they began duty, where they were kept up to date with people’s current and changing 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.

The provider used recognised assessment tools to help determine the most appropriate care and treatment people required.

People’s dietary needs and preferences were recorded in their care plan and staff were knowledgeable about people’s dietary needs.

Food was home cooked on the premises and kitchen staff prepared the right food and drinks for people, whilst also considering people’s preferences and choices. People were able to choose what they wanted to eat from the menu. People told us they enjoyed the food. People told us, “I like the food and get plenty to eat and drink” and “The food is smashing.” A relative confirmed, “[Name] absolutely loves the puddings!”

We observed people having lunch in the dining room and found the mealtime experience was relaxed. Staff asked each person individually what they would like to eat, and some people wereshown the meals to help them make their choice. For people who required assistance with eating, staff provided this to people in a dignified and unhurried way.

A range of drinks were readily available both in people’s rooms and in communal areas such as the lounge and dining room. A relative told us, “They [staff] are always offering drinks around.”

On the day of our assessment, it was a hot and sunny day, and we observed people being offered ice lollies in addition to plenty of fluids.

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.

During our inspection we observed staff working with visiting professionals (community nurses). Staff maintained a record of their visit and outcomes.

People told us they had access to external health and social care resources such as dentists and opticians.

The provider supported people to manage their health and well-being 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.

We observed staff supporting people to manage their health and well-being. Staff encouraged people to spend time in communal areas engaging with other people, to help support their emotional well-being. The provider employed an activity co-ordinator to help facilitate and deliver a range of activities for people. During our inspection we observed people enjoying afternoon tea on the lawn.

n addition to this, people enjoyed activities from external entertainers, such as singers, music therapists and a travelling zoo. Events were celebrated with parties such as birthdays, VE day, Easter and Christmas to which people’s families were invited. A relative told us, “We are invited to all the parties there and for [Name’s] birthday they had a cake and banners, and she was up dancing!”

People told us they thought they were supported to keep active and stay healthy. One person told us, “I like playing bingo and the singalongs. I go in the garden if I feel like it.” Some relatives felt there could be more going on, one relative told us, “There’s not a great deal [of activities] and this could be improved. As its important for people to have stimulation.”

We spoke to the manager about this who confirmed, the activity co-ordinator was in the process of obtaining additional information from people about their backgrounds, so that activities could be made more bespoke to people’s needs.

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.

However, for people who required monitoring due to risks associated from weight loss and skin integrity, records were not always kept evidencing how this was managed.

Records were maintained both electronically and papers based which made some records more difficult to track. We spoke to the manager about this who confirmed this had been identified and plans were in place to transfer all records onto the electronic system.

For one person who required their food intake to be recorded as they were on a modified diet, records were not always detailed enough to track what the person had consumed. For another person at risk from skin integrity, and who required their position changes to be monitored regularly, on some days, there were gaps in records.

However, we were assured people were receiving the care they required, and the issue was one which was caused by record keeping. We spoke to the manager about his who confirmed this issue had been identified and plans were in place to ensure all records were kept electronically to help improve the accuracy of information recorded.

Outcomes were monitored to assess the effectiveness of any support in place and support was amended if required, to help continuously achieve better outcomes for people. The provider had a ‘resident of the day’ review system in place, which looked at key areas including mobility, nutrition and skin integrity. This helped to ensure people’s care and most high-risk needs were monitored, so that care could be adapted accordingly.

One relative was keen to tell us how much their loved one had improved since being at the home, “[Name] was very unstable on their feet before going into the home, but has really improved and has had no falls since being in there."

Although we were assured the provider told people about their rights around consent and respected these when delivering person-centred care and treatment, some people’s records required further detail to help clarity their needs around this area.

For example, for one person who had a Legal Power of Attorney (LPA) in place, it wasn’t clear as what type of LPA, for example, health and welfare or property and finance. For another person, it was recorded that although they had capacity, best interests may be required for bigger decisions, but there was no additional information provided as to what this may look like for that person.

People’s care records evidenced people’s capacity to consent had been assessed. Where people lacked capacity, applications for deprivation of liberty safeguards (DoLS) had been applied for appropriately. We saw how people’s significant others were involved in decisions about their care and support.

People told us they were able to make everyday decisions and choices about how their care was delivered and about how they wanted to spend their day. A relative confirmed, “Staff respect Mum’s wishes and always gain her consent."