Pencombe Hall

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 improved 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. We received mixed, but mostly positive feedback from people and relatives in relation to being involved in their care planning, however, people told us staff knew them well and relatives shared the same views. One relative told us, “Yes, have regular reviews, (relative) is reassessed, we get all of the information in detail”. Another relative said, “There have been no reviews that I know of”. However, people’s relatives told us and records confirmed, regular care plan and risk assessment reviews were taking place. They contained the information staff needed to provide safe care and support, and there was a focus on the information being person centred. Staff had daily handovers to share important information about people and any changes in their support 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. Risk assessments were in place to help identify risk factors specific to each person, such as manual handling, falls, and specific clinical needs. This helped provided staff with information on how to manage and minimise these risks and provide people's care safely. People’s nutritional and hydration needs were met in line with current standards and evidence-based guidance. There was a strong emphasis on ensuring people’s hydration needs were met, this included guidance for staff which was located in different parts of the building for them to refer to when supporting people with hydration needs. Professional advice had been sought where concerns had been raised with swallowing and choking risks. Staff were aware of the guidelines in place for each person who required a modified diet. People told us the quality food was good, and we observed there were snacks and drinks available for people and several food choices were on offer. We saw where people had made specific food choices, these were in place. Additionally, where people changed their mind, alternative meals were provided. One person told us, “If I decide they want something it’s provided without hesitation even for breakfast, for example, if I decide one morning I’d like a bacon sandwich, it would be provided”.

The provider worked well across teams and services to support people. People were supported by staff who had good working relationships with other healthcare professionals and external visitors. These professionals all spoke positively about their working partnerships with the service. One healthcare professional commented, “I’m really impressed with Pencombe Hall, the level of information and detail, communication is great, and how well they know their residents – I’m just really impressed”. People had access to external healthcare professionals, and care plans evidenced the relevant referrals had been made where required. Staff spoke positively about the teamwork within the service, one staff member told us, “All staff are so supportive of each other, when there’s sickness absence no need for agency- staff cover willingly as they know they are genuine absences”.

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 regular healthcare professionals, these included the GP, mental health team, speech and language therapists, dental access and opticians. The registered manager told us there had been some difficulties with accessing hearing services. They had recently explored a provider to visit the home and support people and their relatives with hearing difficulties, who could assess and advise on the most appropriate hearing devices. The service was part of a ‘fit for life’ programme where a person visited the service weekly. These sessions included movement to music, creating music, and a variety of engaging games, including appropriate competitive activities. Staff told us, “Each session is delivered using a person-centred approach, ensuring activities are tailored to the needs and abilities of those attending”.

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. Care plans contained information about people’s health and wellbeing and were regularly reviewed. Although there was no impact to people, we identified people’s daily care interventions were not always recorded consistently, for example, with some personal care entries. However, we were assured as people appeared clean and well dressed. One relative shared how their loved one had improved since living at the service, they said, “They have lived at the service for many years now. Initially their life expectancy was only 12 months, they had severe anxiety when they moved in. Pencombe Hall has had a positive impact, they were encouraged in a gentle way to eat, they have gained weight. They were really deteriorating; their health has improved enormously”. Where people had specific healthcare needs and conditions, these were reviewed regularly by the relevant external healthcare professionals, and any immediate changes were reviewed with the local GP. People’s current and changing needs were discussed in daily meetings.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty (DOLS). People were supported to make choices and have control over their lives. Staff worked in the least restrictive way and acted in people’s best interests. Staff demonstrated a good understanding of the Mental Capacity Act and how to ensure people’s consent was gained. One staff member told us, “Staff are always sensitive to the needs of the residents. One person won't ask for anything even if they need the toilet, so we always ask and engage with them”. We observed staff seeking permission and offering choices with people before they commenced care tasks. Some people chose to have their bedrooms locked during the day; we asked the registered manager to ensure information in relation to people’s choices was documented in peoples care plans. We saw evidence this had been actioned.