Mega Resources Nursing & Care - Gloucestershire

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 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 83 (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.

Assessments of need and subsequent careplans were thorough and detailed.They included person centred life histories, the person’s interests, their likes and dislikes and life routines.

The registered manager was assured staff were meeting people’s assessed needs by carrying out reviews, spot checks and gaining regular feedback from people and their relatives.Staff received specific training to support people with specific needs such as epilepsy and seizure management. People and their relatives told us they were fully involved in their assessment and development of their careplan. Comments included, “We were involved in setting up her careplan, and they keep me updated about her care and wellbeing” and “They are all very kind to my mum, and I am fully involved in her care plan.”

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. They worked to develop evidence-based good practice and standards.

Careplans were developed using best practice guidelines and evidenced based standards. All plans included outcomes, which reflected a developmental element to the person’s support rather than being task orientated. This showed the person was in collaboration with the service to decide what care they needed and how they envisioned the progress of their support and their abilities.

Where each individual had distinct needs, different areas of legislation and best practice was used. For example, the service had attained the Gold Standards Framework (GSF) accreditation for their end of life and palliative care services. GSF is a practical and evidence-based end of life care service improvement programme.The aim is to enable a ‘gold standard’ of care for everyone, with any condition, in any setting, given by any care provider, at any time in a person’s last years of life. GSF aligns with national ambitions for quality palliative and end of life care. People’s care plans contained a clear colour code relating to the person’s level of need. For example, blue indicated the person’s condition was stable with a prognosis of a year or more. This was regularly reviewed.

In people’s careplans, we saw evidence of nationally recognised tools to support nutrition and hydration, dementia, and dietary requirements, amongst others.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

We saw clear recordings in people’s careplans of other professionals involved in their care. Staff liaised with and made referrals (with people’s consent) to professionals including their GP, speech and language therapist, community nurse or the falls clinic, amongst others.

We had very positive feedback from health and social care professionals who worked with the service. Comments included, “They actively foster collaboration and are dedicated to addressing the unique needs of both the caregivers and the clients in their homes. For instance, during a particularly challenging situation with a client who had high expectations, the management and care team worked hand in hand with our [adult social care] team to ensure a positive, constructive atmosphere, which significantly improved the care delivered”, “Prompt notification to healthcare professionals. Escalation to social work and safeguarding teams where required. Monitoring for adverse outcomes. Review of care arrangements and equipment. Implementation of preventative actions to reduce recurrence” and “I have always found [manager] and [provider] to be extremely responsive and efficient when dealing with referrals and enquiries. Communication is excellent, with emails answered promptly and information provided thoroughly.” Social care professionals told us due to the providers consistency of good practice and outcomes, they worked closely with them on new care projects designed to provide safe, timely hospital discharge care packages at home.

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’s specific health needs were recorded in their careplan with relevant information and guidance for staff about the health conditions, presentation and how to fully support them. People were encouraged to make healthier choices to prompt and maintain their health and wellbeing.

A relative told us, “The service is running very smoothly, and he is very happy with the care he gets. He enjoys spending time with his care workers, and his health has improved over the past year.”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

All accidents and incidents were thoroughly recorded, including dated evidence and outcomes.

Thorough investigations into each incident, complaint or concern and changes in persons need were recorded in detail. For example, the providers audit trail included who was involved (including external partners); when the incident occurred and was reported; a RAG rated response urgency; whether the care plan and risk assessment was reviewed and updated; detailed outcome comments with progression of the incident, lessons learned and whether the incident and outcome was dealt with according to the CQC’s key questions of safe, effective caring, responsive and well led.

For example, a person receiving support was in hospital and recorded as a ‘near miss, failed hospital discharge red response urgency’ and a safeguarding referral was raised.The service liaised urgently with the hospital to gain the person’s discharge assessed care needs. The risk was managed safely, the service acted promptly by maintaining consistent contact with the person and the hospital. By following up, escalating concerns, and clearly outlining the need for discharge notice, they ensured the hospital re-engaged with them and confirmed plans. This proactive approach helped prevent a failed discharge and ensured care arrangements could be put in place safely.The outcome was successfully managed and the person returned home safely with the required package of care at short notice.

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

People’s views and wishes were taken into consideration and account when their care was planned with them. Staff ensured people were offered choice and sought consent at every stage of care delivery. Comments included, “I always ask before I do anything” and “It is important to offer choice and ask how I can help them.” One relative told us, “They do ask [family member] we are happy with the service, we feel her care is good and personalised.”