Quinnell House

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 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, however this was not reflected consistently in peoples’ documentation. This was acknowledged and training for staff recording was to be arranged.

People's health and social care needs were assessed before coming to live at the service; the impact of these had been fully considered and there was information about what was important to people and how they would like their care and support to be delivered. This had also ensured the service could meet the identified needs of the person and that staff had the necessary training to keep them safe and well. There was evidence of family involvement within the documents regarding mental capacity but not in other areas such as care delivery.

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 used nationally recognised tools to assess and monitor people’s needs and any risks they faced. This included the risk of moving and handling, continence and skin damage. Staff understood the measures needed to minimise these risks including the importance of encouraging movement and promoting continence. They appropriately supported people with this where required.

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.

Positive relationships had been built with a range of health and social care professionals. Staff told us the GP visited regularly and could be called upon as required. This ensured consistency and enabled people’s needs and their medicines to be regularly reviewed. Referrals to other professionals for advice or a visit, were made when needed. There was evidence of the occupational therapy team involvement with one person regarding safe moving and handling whilst in a distressed mood.

Records demonstrated people were seen by a podiatrist, chiropodist and other health professionals related to their needs. This included the frailty team, diabetic nurse and hospital teams.

Families told us their loved ones were able to see various health care professionals in response to their needs. “I think they are good at referring to specialists, but I do worry about dentists, it seems to be difficult to find one that visits care homes.”

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.

Staff encouraged people to remain as independent and mobile as possible. One visitor told us, “They keep people active, and drinks and snacks are always available, they let us know if there is a problem.”

There were processes in place to guide staff about how to support people to lead healthier lives. People were encouraged by staff to eat healthy meals and drink regularly to maintain their physical health. They were encouraged to be active, and to take part in group activities.

The management told us that they had recently changed to a meal provider for the main midday meal as it was nutritionally designed for elderly residents, including those with special dietary needs such as weight loss and dysphagia (difficulty in swallowing). They still provided home-made cakes, suppers and breakfasts from their in house catering team, which everyone enjoyed. They said additional milk and cream were added to some foods to enhance weight gain, although weight loss was also supported if needed. The feedback from people was mixed about the food, but the return of uneaten food was minimal. People were encouraged to drink plenty of drinks and this was monitored as much as possible by staff. We saw people approach the servery in the dining room for drinks and snacks throughout the site visits, but not sure who records the amounts drunk.

People were encouraged to maximise their mobility and use equipment to aid safety as necessary. Staff supported people to see friends and family and there were people who went out regularly and staff ensured they had the necessary aids to manage trips out safely.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Clinically recognised tools were used to measure aspects of people’s care. For example, the Waterlow Score which indicated people’s likelihood of developing pressure sores and the Malnutrition Universal Screen Tool (MUST), which showed people’s risk of malnutrition. However, it was not clear whether results, trends or patterns were acted on by the service. We saw examples of where people had been recorded as having lost significant weight during a short period of time and although recorded, no action or further review had taken place. Reviews had not identified these trends, which had been highlighted using the MUST tool, with care plans being marked as ‘medium to low risk.’ The provider has now reweighed all the people currently living in the service.

Staff monitored peoples’ health monthly by taking blood pressures, pulses, oxygen levels and temperatures. However, when irregular recordings were documented, these were not always shared and discussed.

Families told us that they used to be involved in monthly reviews about their loved one’s care, but this has not happened in the past year. These were now being re-introduced as a priority.

There were records that demonstrated appropriate referrals had been made for people who required additional clinical support. This included referrals to the occupational therapy team, speech and language therapy (SALT) and the older people’s mental health team. However, the outcomes of these were not always fully explored or documented so that all staff had the same information.

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

People were involved in deciding the care and support to be provided as much as possible. Staff confirmed that they didn’t take people’s consent to care for granted. One staff member said, “People differ every day, sometimes they are more agreeable to receiving help than other days, so if they don’t want support, we wait and return.” Staff told us they asked for consent at each visit before providing any support. Staff understood people had capacity to make decisions about the personal care and support they received. One told us, “We don’t provide care unless agreed to.”