Hatfield Manor

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 67 (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 were completed before people moved to the service. However, staff we spoke with told us that information received was not always sufficient or timely. Despite this, people and relatives gave positive feedback. A relative told us, “There was an assessment process done by one of the managers and we had a full conversation. A care plan was made, and I may have signed it.”

The provider used a ‘Resident of the Day’ system which identified a person (or people) to be the focus for the day where a number of aspects of the person’s care and experiences were routinely reviewed. Staff told us that people’s needs were reviewed, and they were informed of any changes via handover.

We saw that most of the care plans were detailed and up to date. Recognised tools were used to assess people’s level of risk in relation to aspects of their health such as Waterlow, for skin integrity, and MUST, for nutrition.

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 were in receipt of care which considered their preferences and what was important to them. Care plans included information about how to ensure people received the right care and treatment including their likes and dislikes.

People told us they had enough to eat and drink and enjoyed a variety of foods.

On the day of our visit, we saw the lunch time meal was well received and people were offered the support needed to enjoy their meal and interact with others.

The provider had a system in place to ensure policies were kept up to date and shared with staff. The management team confirmed they accessed the support of partner agencies to enable them to remain up to date with current best practice.

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.

People had access to a health or social care professional when needed. A relative told us, “[Person’s] health needs are checked. The 111 service is used when needed but there’s always the weekly G.P visit.”

Staff told us they knew how to respond if there were any changes in a person’s health and were confident in escalating their concerns to senior staff or health care services if needed. However, some care staff shared they felt they would benefit from having more information shared with them by senior staff and the nurses on duty to improve their knowledge of people’s health needs.

Care plans included a record of information relating to health and social care support provided by external professionals.

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 had access to a range of health services. A relative told us, “Yes, they (staff) provide support to meet health needs. She had a [episode of ill health]. They used a multi-disciplinary team to talk about it and [specialist] team to see if changes were needed. There’s a GP every week and that’s really helpful.”

Daily flash meetings were held with senior staff to enable oversight of people’s health and wellbeing, with a view to cascading this information to care staff at handovers.

The provider routinely monitored people’s care and treatment. However, they did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Records detailed people’s outcomes were the provision of the care assessed as required. They did not always include goals or aspirations for people and, for some people these also lacked content and detail. The management team confirmed that they wished to develop care planning further with more input from relatives via ‘Resident of the Day’ along with input from the newly appointed clinical lead and a registered manager, once appointed.

There were systems in place to have an overview of clinical risks for people such as wound management, nutrition, infections and hospital admissions however, as described in the Safe domain of this report, these required to be embedded into practice.

People’s care plans were routinely reviewed, via the ‘Resident of the Day’ process with some positive outcomes shared with us by both people and their relatives. A person told us, “I’m feeling safer on my feet now and am eating much better.” A relative told us, “A review was done in [month]. [Person has] improved a lot since [they] came out of hospital. [Person] has [medical condition] and it’s now stable.”

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

Processes were in place to enable people to make their own choices. Staff knew and understood people’s communication needs and adapted their approach when needed.

Where people were unable to communicate their own wishes, or give consent, a best interest’s process was undertaken with relevant stakeholders. A relative told us, “I haven’t got Power of Attorney, but the home always seeks my views.”

People’s care plans included capacity assessments which detailed how their capacity for the decision was assessed. Where needed, best interest decisions were made, and also Deprivation of Liberty Safeguards (DoLS) were requested or in place. We found that the log of DoLS applications held was inaccurate and had details of 12 people no longer living at the service included. The interim manager updated this record immediately following our feedback. The management team confirmed they were making ongoing checks and reviews of documentation in place.

Environmental restrictions were seen to be in place. These had an impact on the freedom of movement of people, particularly on the first floor of the service. The provider confirmed these were reviewed following our feedback on the equity of experiences for people.