Crescent 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, promoted a good quality of life and was based on the best available evidence.

At our last assessment this key question was rated 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 did not always ensure people’s care and treatment were fully effective because staff did not consistently review and discuss people’s health, care, wellbeing and communication needs with them. People’s needs were assessed before moving into the home to confirm the service could meet their needs and that appropriate equipment was in place. Records showed people’s health was routinely monitored and referrals were made promptly when concerns were identified.

However, some health-related assessments and risk tools were missing or out of date. For example, one person with heart failure was on a fluid restriction in practice, but this was not recorded in their care plan. Another person with diabetes had no diabetes-specific care plan, and the diagnosis was only referenced in their nutrition notes.

The provider responded promptly during the assessment by updating the care plans with clear instructions for staff and gave assurances that all care plans and risk assessments would be reviewed to ensure accuracy and completeness.

The provider did not always plan, deliver or review people’s care and treatment in line with current evidence-based guidance.

Care records were not always complete or accurate, which limited the provider’s ability to show that safe and effective care was consistently delivered. One person with a catheter was independent, but their care plan said staff were supporting them. This meant staff relied on verbal information rather than accurate written guidance.

Repositioning/turning documentation and oral care records were not consistently completed or reviewed. This limited assurance that pressure area care and oral hygiene were delivered in line with evidence-based guidance.

The provider took prompt action to update the records once these gaps were identified and confirmed that all care plans would be reviewed.

Although there were shortfalls, people and relatives told us staff delivered good day-to-day care and responded quickly to health needs. A relative said, “They quickly worked out how best to help him with his support boot … it’s progress,” and another told us, “She’s really perked up since moving here, eating better and getting health checks.” Weight trends were monitored and, where concerns were identified, dietetic advice informed changes such as fortified meals and enhanced snacks. Reviews and follow-up entries evidenced that these changes were checked for impact over subsequent weeks. Health appointments and professional instructions (for example, GP or community nurse) were logged and then incorporated into people’s daily support.
 

Overall, staff provided effective care and treatment that improved people’s wellbeing. However, incomplete documentation of care and health conditions meant the provider could not always demonstrate that care was consistently delivered and reviewed in line with evidence-based guidance.

The provider worked well with other professionals and services to support people’s health, wellbeing and independence.

People were supported by staff who communicated effectively with GPs, district nurses, physiotherapists, dietitians and other visiting professionals. Advice from these professionals was recorded in people’s notes and acted upon. One person was admitted on a rehabilitation pathway that involved regular physiotherapy sessions, and another was referred to the dietitian after weight loss was identified. These examples showed that staff worked in partnership with external professionals to ensure people’s needs were met.

Staff said teamwork within the home was good and that handovers kept them informed about any changes in people’s health or care needs. During the inspection, we saw staff interacting and communicating well with each other, ensuring care was coordinated and consistent.

Records confirmed that appointments with health professionals were documented, and outcomes were followed up. Relatives also told us that staff kept them informed when their family member was unwell or had attended appointments.

Staff and health professionals worked effectively together to provide coordinated care and promote positive outcomes for people.

The provider supported people to maintain good health and wellbeing through effective monitoring, timely referrals, and regular access to healthcare professionals.

Records showed people’s health was reviewed routinely, and referrals were made promptly when concerns were identified. People experiencing weight loss or at high nutritional risk were referred to the dietitian, and those with mobility needs received support from physiotherapists or the community nursing team.

People were encouraged to eat well and maintain a healthy diet. The cook worked closely with care staff to ensure meals met individual needs, including modified textures, fortified options, and preferences linked to religion or health conditions such as diabetes. A family member told us, “She’s happy, she likes activities and she’s eating well.”

People described the food as satisfactory overall, though some mentioned room for improvement. Comments included, “It’s not bad at all, I can’t complain, and plenty of drinks through the day.”

Staff promoted people’s independence wherever possible. Some were supported to manage aspects of their own care, such as personal hygiene or continence needs, while others joined light exercise and leisure activities that supported both physical and emotional wellbeing.

People received proactive support to stay healthy and live meaningful lives. Staff promoted independence, wellbeing and choice through effective coordination and holistic care.

The provider monitored people’s progress and used review information to improve care. Records showed health outcomes were tracked and acted on, and people experienced improvements in wellbeing.

Falls were followed up with recorded post-fall observations and actions. Where patterns were identified, additional measures such as sensor equipment and closer observation were put in place to reduce recurrence. Wound care was overseen with input from district and tissue-viability nurses; dressing schedules and progress notes evidenced healing over time. For people on short-term rehabilitation pathways, physiotherapy goals and reviews were recorded and used to plan day-to-day support and discharge planning.

People and relatives told us they had seen positive changes after admission, and records corroborated this through updated notes from health professionals and care reviews. This demonstrated that monitoring led to tangible improvements in people’s health and independence.

Although systems to collate outcomes were still developing, the evidence showed regular review and timely follow-up that supported sustained progress for individuals.

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

The provider sought consent to care and treatment in line with legislation and guidance. People were supported to make their own choices wherever possible, and decision-specific capacity assessments were carried out when there were concerns about a person’s ability to decide.

Records showed that Mental Capacity Assessments (MCAs) were completed for specific areas such as medication administration, use of bedrails, and consent to personal care. Where people were found to lack capacity, best-interest decisions were recorded and included involvement from relatives or representatives. These decisions clearly documented what was considered, who was involved, and why the agreed action was the least restrictive option.

Staff understood how to apply the principles of the Mental Capacity Act 2005 in day-to-day practice. They explained how they offered choices about meals, clothing, and routines, and sought verbal consent before providing care. We observed staff explaining what they were doing and waiting for people’s agreement before continuing.

People’s records included signed consent forms for sharing information, taking photographs, and receiving personal care.

The provider acted in accordance with the Mental Capacity Act. People’s rights, consent, and preferences were respected, and best-interest decisions were made and reviewed to ensure care remained lawful and person-centred.