Abbey Dean

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 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 robust procedure was in place to assess people’s needs which included pre assessment before people received care, followed by regular reviews of their care documents. People were involved in the creation of their care plans which included an additional one-page profile containing people’s preferences, individual support needs and the activities they enjoy. This document meant people were more likely to receive consistent support by providing new staff alongside agency staff with quick access to the guidance they needed at the point of care. One person said, “They ask me about what I need support with and keep me updated about changes.” Communication care plans were in place providing staff guidance to follow promoting effective communication between people and the staff supporting them.

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 was informed and delivered with the use of tool’s including the Malnutrition Universal Screening Tool (MUST) to identify if people were malnourished or at risk of undernourishment and obesity alongside the Waterlow assessment to identify people’s risk of developing pressure ulcers. A social model of dementia care was used by the provider, which focused on environment, history, psychological needs, and abilities to promote people’s independence, choice and wellbeing.

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.

When people needed the input from specialist services they were supported with effective referrals. For example, people who had a risk of choking identified were referred to the Speech and Language Therapy team (SaLT) which provided guidance to reduce risk and for staff to follow. Following hospital discharge people had their needs reassessed to ensure support reflected their current needs. Staff had access to up-to-date information required to support people at the point of care through the use of electronic devices. One staff member said, “When a person’s care plan changes, we get notified on our devices, it makes it easy to stay informed about their support.”

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 and reduce their future needs for care and support.

People were supported to access their GP when needed and supported to arrange dentist and optician appointments. Staff had guidance to follow around people’s individual nutrition and hydration needs and people had choice around their food and drink. One person said, “I get asked about what I like to eat and drink, I wanted crumpets for breakfast, and they got them for me.” Another person said, “They know I like fruit for pudding and make sure I get it even if it’s not on the menu that day.” A staff member said, “Not everyone likes water but there are healthy options like flavoured water which encourages people to drink more.”

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.

The registered manager and senior staff consistently reviewed people’s outcomes. For example, people were supported to arrange and attend medication reviews ensuring the medication people were taking was appropriate and met their needs. People told us their outcomes were positive. One person said, “I was having falls before I moved here and now, I’m having less and feel safer.”

Staff responded quickly to a person’s deteriorating health by involving healthcare professionals and following treatment plans, which prevented further hospital admissions. They supported the person's wellbeing through a personalized activities programme based on their interests and goals, increasing their community participation.

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

People told us staff always sought their consent before providing care. We observed staff knocking on people’s doors and waiting for responses before entering their bedrooms. One person said, “They talk me through everything and check if I’m happy to proceed.” Staff knew the principles of the Mental Capacity Act (MCA) and had received training on this subject. A staff member said, “It’s there to support people if you have a doubt about a person’s capacity to make a certain decision, you should always presume capacity but if a person doesn’t have capacity there should be a best interest meeting and the decision should be the least restrictive.” Where needed the registered manager had consistently supported people by completing an MCA to ensure any restriction was made in line with current legislation. Where restrictions were in place, the registered manager made DoLS applications to support people’s safety who lacked capacity to make certain decisions and where granted ensured any conditions were met.