Chartwell 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 for this newly registered service. This key question has been rated 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.A detailed needs assessment was completed with people, their relatives and health care professionals before people were offered a service. This was to ensure staff had the skills and knowledge to provide the care people needed. The assessment covered all areas of people’s lives including their preferences, life history and health. People were asked to share information about any protected characteristics to help staff provide care in the way people preferred. This included any disabilities, or cultural and spiritual needs. The information people shared was used to plan their care and support.

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 understand people’s needs and any risks to them. This included the risks of skin damage or malnutrition. These were completed at least monthly to understand if people’s needs had changed and their care needed to be offered in a different way. Local health care professionals used the same assessments to understand people’s needs when staff shared assessment results with them. People who were at risk of losing weight were offered food fortified with extra calories and snacks between meals in line with national ‘Food First for Care Homes’ guidance.

We observed a lunch time meal, people received the meals in line with their needs including texture. People were offered choices of meals and different options were offered when people did not want any of the choices. One person was not eating their meal as they were not hungry, they requested a sandwich which was supplied.

People sat in small groups to eat their meals, and the chef spent time with people checking they were happy with their meals and offering second helpings. People told us they liked the food, and they had enough to eat.

The provider worked well across teams and services to support people. There were systems in place to improve working with the GP and district nurses. The GP explained how they completed a monthly ward round to discuss people’s needs. Staff would send up-to-date information to the surgery the week before. Staff recorded people’s vital signs such as blood pressure to assist the GP in their review. The GP told us, staff were proactive in raising concerns about people’s health including skin condition.

People had been referred to other health professionals such as the dietician or speech and language therapist, when changes were identified. Staff followed the guidance provided when supporting people such as the texture of diet and fluids.Relatives told us staff had contacted the GP when their family member was unwell, and this had been done quickly.

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 were supported to use new equipment to support their health. People who were living with diabetes used a system to constantly monitor their blood sugar without having to test their blood. This had enabled people to recognise when their blood sugar was becoming raised or falling and take appropriate action before they became unwell.

People were supported to attend appointments either with family or with staff if people were happy for this. Relatives confirmed people had been referred to health professionals when required. They also told us decisions about healthcare were reviewed and updated when required. A relative told us, “(Relative) used to go to hospital if they banged their head, but they have a Respect form and now only goes in if they are bleeding. I have Lasting Power of Attorney and have given consent.”

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. Some people required staff to monitor their diet and fluid intake to support them to be as healthy as possible. For example, people had optimum fluid intake targets to reduce the risks of urinary infection. People’s fluid intake records were reviewed at midday to identify if action was required to make sure people reached the target.

When potential risks to people’s health and welfare had been identified such as skin integrity, staff supported people with the use of equipment and changed their position to keep their skin healthy. Staff understood their role in monitoring people’s care and making changes when the care plan was no longer effective.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff told us how they supported people to make day to day choices, we observed this during our inspection. People were able to choose where they spent their time, what they wanted to eat and wear.

When people had been assessed as not having capacity to make decisions, staff had followed the Mental Capacity Act 2005 (MCA). Best interest decisions had been made, there were accurate records of how decisions had been made and who was involved. Staff were aware of who had been appointed as people’s legal representative, they had been involved in making decisions.

Depravation of Liberty Safeguards (DoLS) had been applied for as necessary. There was a process in place to track and monitor applications and when authorisations needed to be renewed. When authorisations had been received these had been recorded in people’s care plans, there were currently no conditions on the authorisations in place.