Prestige Nursing- Ashby De La Zouch

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 75 (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. Staff fully understood these needs and worked well with people. Staff had a good understanding of people’s needs because they had the time to get to know them. Staff told us, “We are given care plans ahead of any new packages and managers talk through people’s care beforehand so we are clear on people’s needs and expectations.” Staff explained they were only able to support with complex health care tasks when they had been trained and assessed as competent by the clinical nurse. A relative confirmed there was a detailed assessment of their family member’s needs with them, including clinical assessments and specialised training for staff to ensure they were effective in meeting the person’s needs. Continuity of care was a strength of the service. People were allocated a team of staff who were compatible in terms of skills and aptitude.

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. The registered manager demonstrated a sound understanding and application of current good practice to assess and act on people’s needs. They ensured care planning was detailed, rigorous and gave staff the right level of information to meet people’s needs. People received support from staff who knew them well, and who had the right training and support. Training was comprehensive and had regard to good practice and current legislation, including delegated healthcare tasks. A relative told us, “[Name] has complex needs and uses medical equipment to help them eat and manage. Staff are all trained (to undertake specific tasks) and they are all brilliant.” A second relative described how staff were skilled at identifying when their family member was at risk from a health crisis and taking timely action to prevent this by giving the right care and treatment. People’s care plans including key information to support staff to respond in a crisis. For example, what the person may look like or respond if they were unwell, key symptoms of stroke, sepsis, heart attack and what to do if someone was bleeding heavily. Guidance was based on current based practice and designed to support staff to provide effective immediate care whilst waiting for medical assistance.

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. The registered manager and staff demonstrated they knew people well, including their life history and experiences, what and who was important to them and their ambitions and goals. They helped people to tell their story and have their needs met consistently and safely. Staff shared relevant information and worked with families and external health and social care professionals to ensure people’s needs were understood and their wishes heard, for instance when multidisciplinary team meetings were required. This helped to ensure people had the right support in a timely way. Staff supported each other well, working flexibly and compassionately with each other. Leaders role modelled the caring approach they wanted staff to take. Staff told us, “We have consistent staff and support each other as a team. There is really good communication between handovers and solid relationships with families” and “[Managers] are very involved and encourage and support us to do our best for people. For example, [Name of clinical lead] visits people and their families regularly, works alongside us and goes on [medical] appointments with people so information sharing is good.”

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 worked with people and health professionals to understand what people needed to stay healthy. For example, staff worked with people’s families and delegated healthcare staff to undertake essential tasks that helped people, including children, to avoid a crisis in their health and reduce the risk of unplanned medical intervention. Staff supported people to access routine and specialist external health and social care professionals when they needed them. People and relatives told us, “Staff let me know straight away if [Name] is unwell. They know [Name] really well so can point out if something isn’t right and we can deal with it” and “If I’ve been under the weather, staff ask if I want to get a health professional in. They are very helpful; they know my limitations.” Staff supported people with meal choice and ensured they had enough to eat and drink where this was needed. A person told us, “Staff do meals in the evening; they go in the fridge and give me a choice.” A relative described how staff were competent in supporting their family member to receive feeds through a feeding tube. They told us, “Staff will put the feed on, and they know how to make up the feeds. They know the timings, and the paperwork is all in place.”

The provider 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 worked to achieve reductions in crisis situations and the use of restrictive interventions with improved outcomes for people. A relative told us, “Staff just know [Name]. They know [Name] needs extra time in the morning and they don’t rush. They make sure [Name] relaxes by reading a book to them, playing with them and massage.” The relative described how this approach had resulted in a significant reduction in the person’s distress and overall improvement in their wellbeing. Staff regularly reviewed people’s needs with people and those important to them to ensure they were achieving the outcomes they wanted from their care. A relative told us, “Yes [Name’s] care is always being reviewed, [clinical lead nurse] comes regularly to review and update the care plan. It’s reviewed regularly with us; we have constant contact.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Leaders and staff had a clear understanding of the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received training regarding the MCA and policies were in line with the principles of the MCA. Staff told us, “We always seek consent, either verbally or through watching responses and body language to make sure people are happy with what we are doing.” People were supported to have maximum choice and control over their lives. A relative told us, “Staff will always talk to [Name], give them a choice so they are making decisions. They use hand signs to make 2 choices. They wait for [Name] to decide as [Name] is only able to make a choice between two things.” Staff supported them in the least restrictive way possible and in their best interests. Staff sought consent and ensured people and families were involved in decisions about their care. Staff took care to ensure mental capacity assessments were decision specific, and that capacity was always assumed in the first place. Where there needed to be a restriction to support people safely, this was reviewed comprehensively to ensure all other options had been considered