Portsdown View

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 did not provide a rating for the service. At this assessment, this key question has been rated Outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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.

People's needs, choices, care, treatment and support had been assessed before using the service. This included establishing peoples' protected characteristics to ensure their diverse needs and preferences were met.

Nationally recognised assessment tools were used to determine people's support needs and specialist assessments undertaken by professionals external to the service were included in care plans to inform staff about how best to meet people's needs.

People and relatives told us people were involved in their care and staff listened to them and they were positive about the effectiveness of their care.

Staff made appropriate use of technology to support people. Pressure relieving equipment and falls prevention technology was used safely and in accordance with people's needs.

The provider always 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.

Evidence-based practice was consistently embedded into the delivery of care. Staff used recognised assessment and clinical guidance alongside personalised knowledge of each person to deliver care that reflected both best practice and what mattered most to people. Examples included support needed with their nutritional intake, skin integrity support and how people wished to take their medicines.

Numerous innovative, evidence-based initiatives had been developed by the provider that achieved exceptional outcomes for people. For example, its organisation-wide Dementia Strategy promoted relationship-centred care by enabling staff to understand each person’s life history, strengths and aspirations, resulting in significant improvements in people’s wellbeing and quality of life. One person moved to the service following several unsuccessful placements. Staff took time to understand their underlying needs and introduced personalised approaches that resulted in the person becoming more settled, content and enabling them to thrive within the service.

Staff also used a pain assessment app for people unable to verbalise pain, ensuring physical causes of distress were identified and treated before behaviours were attributed to dementia, reducing unnecessary interventions. One staff member told us this had resulted in a decrease in anxiety reducing medicines for 1 person.

The providers ‘Food First’ strategy improved nutritional outcomes through personalised food adaptations. Records demonstrated this had positive results and the chef told us, “We have seen a good increase in weights. Some people have gone from a [very high-risk nutritional status] to a 0 risk. It’s nice to see it works.”

People experienced a highly responsive and person-centred approach to nutrition. The chef built positive relationships with people, taking time to understand their individual preferences, dietary requirements and health goals. One person told us, "The head chef has been working with me. She comes to see me quite often and has given advice. She adapts the menu just for me. It’s working very well." People could request freshly prepared meals at any time, and the on-site bistro offered drinks and healthy snacks. People and relatives consistently praised the variety and quality of the food.

The provider 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.

The registered manager and staff told us they had been on a journey to strengthen partnership working since the home opened, with significant improvements achieved. Over time, the service had developed a strong culture of collaboration, where staff and external professionals worked together to ensure people received coordinated and person-centred care. For example, 1 person was very well supported to manage their health condition in collaboration with a partner agency.

External professionals told us of strong partnership working between them and the service. For example, 1 said, “We are a team. We work together. I can’t fault them.” This resulted in highly effective support for people. For example, partnership between an external team and the home had significantly improved 1 person’s mobility. The professional involved described the person’s progress as “amazing” and commended the team for their commitment and work.

Records demonstrated, and professionals told us, staff were exceptionally responsive in identifying when people required support from partner agencies. They contacted healthcare professionals promptly, made appropriate referrals and followed any guidance provided, helping to ensure people received timely, appropriate care and positive outcomes.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider was proactive in supporting people to achieve the best possible health outcomes through a preventative approach that promoted health, wellbeing and quality of life. For example, they employed a physiotherapist and personal trainer who delivered tailored exercise programmes, including a structured falls prevention programme designed to improve strength, balance and confidence. These interventions achieved positive outcomes. We saw feedback from 1 person that stated, "I feel much more confident. I feel stronger and that my balance in general has improved." A staff member also told us how a specific exercise programme had significantly benefitted another person and said, “[Name] came in needing a full body hoist and was unable to move independently. Yesterday, she walked into Portsmouth and up the Spinnaker Tower.” A relative also told us, "[Name] is the best she has been for a long time. We have just got back from a [health] appointment, and they have given her the best report yet. I think it’s because they (staff) have her doing exercises, yoga and more which has made all the difference."

Another person admitted following self-neglect was supported through consistent, respectful relationship-based care to rebuild confidence and self-esteem, which empowered them to look after themselves again. It was so successful, they were able to return home although kept links with the home.

The provider further promoted healthy living through a ‘health calendar’, with themed initiatives focusing on areas such as joint health and oral care. Relatives told us, "There's been a lot of care taken over their (people’s) health. I have nothing I’d like to change here about their care. It’s been wonderful.”

Staff worked proactively and jointly with people and healthcare professionals, using an evidence-based health monitoring tool to identify changes in health early, anticipate clinical needs and seek timely advice. This enabled appropriate escalation of concerns and prompt referrals, ensuring people received coordinated, responsive care that prevented deterioration. One healthcare professional told us, "The staff are very familiar with their clients and are able to identify risks to people's health and well-being early to avoid any deterioration."

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.

Staff responded effectively to changes in people's needs, such as monitoring food and fluid intake and taking prompt action when concerns were identified. Professional advice was sought quickly when risks arose, Continuous monitoring, alongside timely professional support contributed to effective outcomes for people.

There were many examples of where some people had achieved significant outcomes that changed the quality of their life. People benefitted from a wide range of meaningful, personalised engagement. Despite this, some people told us they would have welcomed more social opportunities. The provider had recently introduced a recognised activity resource to more easily monitor engagement for all people. This demonstrated a proactive approach to improving outcomes and ensuring all people's interests and wellbeing remained central.

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

People told us staff asked for their consent and involved them in decisions about their care and support. They said their choices were always respected.

Where people lacked capacity to make specific decisions, the principles of the Mental Capacity Act (MCA) were followed. Staff received training in the MCA and understood how to apply this to their daily practice.