Tilsley House Care Home

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. The provider was previously in breach of the legal regulation relating to person centred care. Improvements were found at this assessment and the provider was no longer in breach of this regulation. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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. Improvements had been made since our last inspection to ensure care plans were person centred and contained detailed information about people’s needs. People’s care plans described the support they required and their preferences. Staff we spoke with demonstrated they knew people’s needs well. A health and social care professional said, “They know their residents very well and can spot when someone is not well or something is not right.” Staff regularly reviewed care plans to ensure information was accurate and up to date. People had communication care plans. For 1 person, where English was not their first language, staff supported them through using cards, pictures and communication tools. Daily records documented the support people had received. This showed people received continence, personal and oral care. A person said, “I have a shower every other day.”

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 had met the recommendation made at the last inspection to ensure people’s nutrition and hydration needs were met by monitoring intake if required. Advice was sought or referrals made if people’s food or fluid intake was of concern. People could access food and drinks within areas of the home independently. People were supported and prompted with their food and drink at mealtimes in line with their care plan guidance. We observed alternatives being offered to people who were not engaging with their meal. Staff interacted and worked well as a team encouraging people with their meals. People’s preferences around food and drink were documented in their care plan. Staff were knowledgeable about people’s preferences but did not make assumptions and ensured choices were offered. Picture cards and menus supported people in their decision making. A person said, “The food is good, we have excellent choices. If you tell the chef what you would like, they will cater it for you, they are very adaptable.” A relative said, “Food is really good.”

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. Information was shared and communicated effectively within the staff team to ensure staff were aware of any changes. There was clear and detailed communication between senior staff members. People had a hospital pack with information included such as current medicines and communication needs. This was available should an admission be required. Staff were clear of their roles and responsibilities and made sure areas they were responsible for were followed up where necessary. A staff member said, “We work well as a team together.”

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. Care plans gave information about any health conditions and what staff should be observant of. For example, signs and symptoms were clearly documented around diabetes management. Care plans described how to support people with their oral care, skin integrity and mobility. People’s involvement in daily care tasks was supported and encouraged. A staff member told us how the staff team knew people well, “If people are unwell, we notice and do something.” A relative said, “Staff are meticulous about how they keep an eye on [Name of family member]. Things are caught quickly. A urinary tract infection (UTI) was identified quickly.” The service had positive relationships with the GP, pharmacy and other health professionals. The service acted on concerns and made referrals as needed. A health professional said, “The home escalates appropriately. Information is ready when we come in. Any actions we request are completed.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Staff regularly reviewed people’s care and support to ensure it met people’s needs and preferences. People told us they enjoyed living at the service. A person said, “I am quite happy here. People told us staff supported them in the way they wished. A person said, “I have a shower every morning.” A health professional said, “There has been improved outcomes for residents and good communication.” A staff member said, “Things have improved. People have better care as things are better organised.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, the quality of detail in mental capacity assessments and best interest decisions was inconsistent. Mental capacity assessments were conducted where people lacked capacity around a specific area of their care and associated best interest decisions completed. Some demonstrated well how the person had been involved in the assessment, the way information was presented and what was known about the person. Some lacked detail, including who had been involved in best interest decisions and what other options have been discounted. The registered manager said this would be addressed.

People’s views and wishes are considered and reflected in their care plans. For example, 1 person’s care plan described their sensory preferences of preferring the curtains closed and no bright lights. Staff had received training in the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff demonstrated good knowledge about respecting people’s choice and ensuring consent to care interventions was sought. A staff member said, “Consent, we always ask.” This was observed when staff asked people what and where they wished to eat and how they wanted to spend their time. A person said, “I can get up and go to bed whenever I want. I have lots of freedom.”