Melbreck

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 71 (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 and relatives were involved in initial and on-going assessments. Records were person-centred and reflected what was important to the person. The registered manager told us, “We go and carry out the assessments, to make sure we are the right fit for people, and we can meet their needs. We have in-depth meetings about the person’s needs. We have a transition period, we register them with the GP, and ensure we have everything in place for them.”

Pre-admission assessments were comprehensive. They contained details of the person, their preferences, health conditions and all aspects of their lives. Based on this, a plan was devised on how to best support the person. Care plans were developed from the initial assessments and were regularly reviewed and updated as people’s needs changed.

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 needs were monitored and reviewed to ensure they received consistent care and support that met their needs. Following an extended stay in hospital, a person had lost some of their abilities and skills, such as using the commode and using their communication device. They also became stressed when being repositioned using a hoist. With patience and dedicated care and encouragement, the person had begun to regain their skills. They had started to use their communication device effectively, so communication was improved and were also able to use the commode again. They had also started to go to a resource centre 3 days a week, which they enjoyed. A referral to a dietician resulted in the person gaining weight and becoming healthier. The registered manager told us, “We have weekly meetings with the case worker who is extremely happy with the progress that [person] has made at Melbreck.”

People’s health and nutritional needs were assessed, recorded and met. The staff supported people with their choice of meals by showing them plated meals and drinks so they could indicate their preferences. Relatives commented, “The food is good from what I've seen. Everything is done on site. Cakes and everything”, “The cook is excellent”, “They help [family member] with feeding. They do it in a very caring way and come across as very caring people” and “They know [family member].”

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.

Staff told us they enjoyed working at the home, there was a very good culture and supportive teamwork. A staff member told us, “I think the staff here are really good. They sometimes need a nudge, but we do have a good team here.”

People and relatives told us the staff worked well together and communicated with them well to meet their needs. One relative stated, “They're very good. I'm very pleased at how they're looking after [family member].”

The management team told us they liaised with other professionals and agencies to share information and good practice to make continuous improvement to benefit people. The registered manager told us, “We had the dietician out on Tuesday to assess people on Percutaneous Endoscopic Gastrostomy (PEGs), we have nutritionists and physiotherapists. Some people are privately funded for the use of a hydro pool and visit regularly. We are involved with the speech and language therapy team (SALT) team. The GP surgery has a care home team. The nurse practitioners are mostly involved. We can ring or email and they respond instantly. They carry out checks on people, vaccinations etc.”

The provider always supported people to manage their health and wellbeing to fully maximisetheir independence, choice and control. Staff supported people to live healthier lives and wherepossible, reduce their future needs for care and support.

Relatives felt their family members’ health needs were met. One relative told us, “The nurses are great. They update me if anything changes. They always keep me well informed” and another said, “About a week ago we had a review meeting and discussed [family member’s] needs.”

People were supported to access a range of health care professionals. Care records contained detailed information about people’s health conditions and how these might affect people. Care records also contained relevant areas of health that needed to be maintained and improved. A staff member commented, “The relationship with the practice nurse is brilliant. Prompt on request, always there when you need them. The pharmacist is prompt with deliveries.”

Staff knew people well and demonstrated how they would recognise changes in their health and what they would do if they had concerns. A healthcare professional involved in the care of people told us, “I have seen residents come in from other homes and the Melbreck team have really worked to meet their needs, that had previously not been metand improve their health and wellbeing.[Person] for example, it has taken time, but they are a completely different person from withdrawn to happy and engaging at my visits.”

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.

There was evidence of regular reviews and action being taken immediately following any changes to people’s health needs. People were supported to attend relevant healthcare appointments and the outcome of these was recorded in their care plans. Staff mentioned having a good relationship with external professionals. There was some evidence of ongoing monitoring of physical health needs and inter professional working, such as SALT, GP/practice nurse and dietician. A healthcare professional told us, “They know the residents well, and I am confident that they will contact me between any visits with any issues or concerns they have about the residents.”

People’s needs in relation to food consistency was clearly recorded and visually clear using coloured photographs of menus. There were photographs of people associated with each level of food consistency, to help ensure kitchen staff were aware of their needs and prepared food as required. The chef told us, “I know people’s needs well as I have been here a long time, but should someone cover for me, I want to make sure they have the right information easily accessible.”

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

Although the staff received training in the principles of the Mental Capacity Act 2005 (MCA), some did not demonstrate knowledge of this, and had little understanding of what decision-making in the person’s best interests meant. We raised this with the registered manager who told us, “This is on posters around the building for staff to see and this is also something that is discussed in supervision with all staff including nurses. I will ensure that all staff are put back onto their MCA training. I will then ensure that this is discussed in our morning allocations/handover to bring the knowledge they have to the front of their minds.”

The provider was meeting the requirements of the MCA. People were consulted in all aspects of their daily lives and were encouraged to make their own choices if they were able to. People and relatives confirmed this, and we saw evidence of this during our inspection. A relative told us, “They give [family member] choice and ask [their] consent.”

Where people lacked capacity, we saw decisions had been made in their best interests, and relevant professionals had been involved in the process.