Hesslewood 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. This is the first assessment for this newly registered service under a new provider. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (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.

Care plans contained detailed information about all aspects of people’s care needs. These were updated when changes occurred, or reviews had taken place. However, staff did not always keep clear, comprehensive daily care records to show support had been given. This meant there was not always evidence to be assured appropriate action had been taken in response to people’s needs. This had been identified previously by the registered manager, and we saw previous discussions had been held with staff. We brought this to the attention of the registered manager who took immediate actions to ensure people’s daily care was appropriately recorded and that staff understood this was a priority and why. The registered manager also arranged for additional checks to be undertaken by senior staff.

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.

For example, where people were at risk of malnutrition the service monitored their weights and sought guidance from professionals. However, it was not always clear from records whether people had been supported appropriately.

Some people’s care records did not contain enough information to show whether they had received enough to drink. Our observations within the home showed people always had drinks readily available, and staff prompted people to drink regularly. During lunch when people asked for extra drinks staff were quick to respond. People were very complimentary about the food. One person told us, “Food is lovely, we get plenty and too much, which is good! You can ask for something else, they’re really accommodating.” Relatives’ comments included, “[Person] eats well, [person] has put on weight. They (staff) have been giving [person] some supplements with their food” and “Since [person] had their stroke, they don’t eat so much but I know that [person] eats enough and gets what they like.”

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.

Care plans contained detailed information about when and how advice had been sought from other professionals. Recommendations, for example, about changes to care were documented and clearly understood by staff. Staff were able to describe the appropriate care to give to people. A staff member told us, “We sit down at the end of the day to discuss any changes and then update. We speak to previous shifts such as night staff to day staff changeovers. For example, one person used to like a blanket and now has a quilt cover.” However, we found daily notes about people’s care were not always clear or contemporaneous. This meant it was not always clear whether the service had an accurate understanding of what care had been delivered. The registered manager had identified these discrepancies previously and took action following our inspection visit.

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.

People received immediate support from health professionals when they needed it. The service worked very closely with the GP surgery keeping detailed records of people’s health needs, any improvement or deterioration and advice given during GP visits. A relative told us, “[Person] was still very much down following their long stay in hospital but they (staff) were always encouraging [person] to get up and [person] did!”

People were supported to be as physically active as possible. A number of people enjoyed walking outside and the home had recently led a walking club twice a week, which had a positive impact on these people’s health and wellbeing.

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.

Staff had not always monitored people’s clinical outcomes, such as food and fluid intake to assess potential dehydration or malnutrition. Care records did not always accurately record when staff offered support to people, for example, with their personal or oral care. However, people and relatives told us they were well supported in these areas. One relative confirmed, “[Person] always looks clean and tidy when I go in, [person’s] hair is tidy. When I go in I always check in the bathroom and I can see that the soaps and lotions have been used. [Person] is always clean and well dressed.”

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

People told us their views and wishes were taken into account. Appropriate Mental Capacity Act assessments had taken place. These were person-centred and focused on individual circumstances and care needs. Where people did not have capacity to consent appropriate best interest decisions had been made and recorded.