Signature at Hendon Hall

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 was the first rating for this newly registered service. We rated this key question good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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 did assess people’s needs and in most cases, they made sure people’s care and treatment was effective by assessing and reviewing their health, care, and wellbeing. But there were times when this was not always effective.

People’s needs were generally assessed, and plans were made to manage people’s health and care needs. For example, when people were admitted with a pressure sore, when people had diabetes, and when people had long term conditions such as Parkinson’s disease. However, some needs were not effectively assessed, for individuals who used oxygen, were at risk of choking, needed specialist equipment to prevent pressure sores, and who could get distressed. We found key shortfalls with these people’s risk assessment and associated plans regarding these themes. The registered manager accepted our feedback, and some actions were taken during the assessment to make these improvements.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

There were examples of staff planning and delivering people’s care effectively. However, there were times when this was not effective. People who were living with dementia had assessments and care plans, but staff had not started with the person’s presenting need of dementia in order to fully understand this need. When people presented with dementia related distress records were kept of what happened. But no accompanying plans were in place to direct staff how to manage this.

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.

Staff spoke well of the seniors and heads of care being supportive and helpful in their daily work. They felt people’s needs were effectively communicated to them, especially if these needs were changing. When the provider needed to make changes following our assessment feedback, staff were informed of these.

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.

There was a GP round twice a week to monitor and respond to people who were unwell. Appropriate timely referrals were made to dieticians, podiatrists, and district nurses to respond to changes in people’s health. We were told about 2 people whose mobility needs had improved following the intervention of staff. As a person’s relative told us, “Since moving here [name of person] has changed for the better. He receives regular healthcare support. The GP visits twice a week and is available if needed.” Another person’s relative told us, “We had a meeting today, as [name of person] has not been well. There is good contact with us from the carers and nurse.”

The provider routinely monitored people’s care and treatment to continuously improve it.

Nursing staff, heads of care, and clinical leads were monitoring people’s health needs to improve their health if possible and manage a change in need. A clinical audit took place to check the work of staff was effective. As one person’s relative told us, “I can see it’s a place which lengthens life.” Although, we found some shortfalls in the monitoring of some people’s care, there was also positive work taking place here. The registered manager and clinical lead took actions to address these shortfalls found.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering some aspects of care and treatment.

Heads of care were ensuring those people living with dementia who could be being restricted were having mental capacity act assessments such as those who spent time sitting in a riser recliner chairs who may no longer know how to get out of the chair independently. For those who lacked capacity a best interests process was followed, and people’s relatives were consulted with. However, there were some aspects of people’s care, who were living with dementia, when the principles of the Mental Capacity Act 2005 were not being applied. For example, when people were offered non-alcoholic wine at mealtimes, people were not being told it was not typical wine. Also, when people were asked to consent to having their photos taken and sharing information with professionals. In these situations, a mental capacity assessment should have taken place and a best interests process followed to determine what the person would have done if they still had capacity. We fed this back to the heads of care and registered manager who said they would address these shortfalls.