Mount Vernon Terrace

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.

The provider was previously in breach of the legal regulations related to person centred care and consent. Improvements had been made at this assessment, and the provider was no longer in breach of regulations.

People’s needs and rights were being fully supported. People’s care and treatment was effective due to their health, care, well-being, and communication needs always being assessed with them and relevant external teams. Peoples care plans and risk assessments were kept up to date and regularly reviewed.

The management and staff team showed a good understanding and knowledge of the Mental Capacity Act, including capacity and consent. Staff were clear of how to support people living with fluctuating capacity.

Staff were aware of people’s preferences and respected these in a person-centred way. People were aware of their rights around care and treatment.

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 management team made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The management team ensured co–production was being fully considered where people had the capacity to make decisions about the care and support they wished for. People told us that they were involved with planning and reviewing their care. One person said, “I have seen my care plan and have been involved since moving into Vernon Terrace. I have a monthly review to discuss if any changes need to be made. At present my care plan reflects my needs.”

Support staff on duty during our site visit were observed to be interacting with people in a therapeutic and meaningful manner. We saw staff had a good knowledge of people and their individual needs. Staff showed a good knowledge of what immediate action to take if a person’s needs appeared to have changed. Prompt referrals had been made to external health and social care teams when required.

Staff had access to documents on how to support people. Where people’s needs changed, these care planning documents had been reviewed and updated so staff could understand people’s changes in needs. For example, where a person’s mobility had reduced, we found the service had made a referral to an external health team for occupational therapy input for an equipment review.

The management team 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 service implemented best practice guidance for the management of people’s specific identified needs. For example, where people lived with Epilepsy, the guidance for escalating to the emergency services if a person had experienced a prolonged seizure, was clear, and being followed by the service.

Clear guidance was in place for staff to follow, where people lived with diet and medication managed diabetes, their care plans were clear and robust. Information for staff on supporting an effective low sugar diet, daily checks needed, and what to do if a person became unwell were all clear. Staff we spoke with showed a clear understanding of ensuring people were supported to maintain a healthy diet and fluid intake.

The management team 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.

Feedback we received from people indicated the service worked in partnership with external agencies. The care plans, risk assessments and activity planners for people had been regularly updated when a review had taken place. We found people now had therapeutic, meaningful engagement available. People were enabled to participate as active members of their community.

People gave positive feedback about the support they received from staff and the activities which were offered for them. One person was supported to cook their own meals each day, with ingredients of their choosing. We saw this person happily engaged in this meal preparation with a staff member.

Staff members we spoke with told us about the positive relationships they had with people and their external health and social care teams. One member of staff told us, “I’m quite new to the team, and I’m very happy here. Everything has been explained to me on induction.”

The management team 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 gave positive feedback about the support provided for them by staff. One person said, “I feel the support staff are caring. They support my needs and are polite and pleasant with me. My independence is promoted, staff support me with appointments and medication.”

Where care plans and risk assessments were still being reviewed by the new manager, there was relevant risk information in place for staff to follow. The new manager explained, “They were going back to basics with the care plans, to ensure all areas of people’s needs were reviewed.” The care plans we reviewed which had been completed were significantly improved from our previous assessment. We were assured by the approach of the management team.

The service notice board contained information of events and daily activities that all people could access. The notice board displayed further information on improving physical health and well-being, with a suggestion box for people to express their views of new activities, and events they would like to be considered by the management team.

People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people, and to have a clear understanding of the person’s needs.

The management team 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.

Peoples care and support needs were being regularly monitored and reviewed by the management team. They had improved their daily running records, to ensure they had robust oversight of any changes in people’s needs.

The new manager told us they had ordered various items to improve health and wellbeing for people. These included balls, bean bags and stretching bands, to support people who were less mobile to enjoy chair-based exercise and remain physically active.

Referrals were made to external teams to help mitigate risks effectively. For example, people who lived with drug or alcohol dependency had been referred to professionals for specialist input to help mitigate these risks. The service was working closely with a clinical specialist for substance misuse and the smoking cessation team. Where referrals had been made, the guidance had been updated in people’s care plans.

People's individual needs were being met by the adaption, design and decoration of the premises. The management team explained how they were supported people to personalise their bedroom spaces during the refurbishment process. One person had an interest in a particular rock band. The manager had ordered a gold disc picture for them to put on their wall once decorating was completed.

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

The provider was previously in breach of the legal regulation in regard to consent. We found improvements had been made at this assessment, and the provider was no longer in breach of regulation.

People felt they were supported by staff in their best interests, with their consent and in the least restrictive way. One person said, “I find the staff caring and respectful. The staff always ask for my consent before providing personal care.”

All of the staff we spoke with understood the importance of respecting people’s wishes and asking for consent prior to providing support or personal care.

We observed staff knocking on people’s doors and waiting for a response prior to entering. People were addressed by their preferred names and pronouns by staff in a respectful manner.

The management team ensured they were working within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

Systems and processes were in place to ensure service users were always supported to make decisions about their care and treatment within the principles of The Mental Capacity Act 2005 (MCA). Service users’ capacity to understand decisions had been assessed. Mental capacity assessments that had been completed had followed the principles of the Mental Capacity Act (2005).

Mental capacity assessments and best interests’ decisions were appropriately completed where service users had restrictions placed on them. The provider ensured systems and processes in place were able to identify and uphold service users’ deprivation of liberty safeguards.