Haviland 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 requires improvement. At this assessment the rating has changed to 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. Preadmission assessments provided an overview of health, social and wellbeing needs and preferences, we reviewed a very newly admitted person’s assessment which contained a high level of detail. A member of the management team told us how they conducted assessments where possible in people’s homes or where they felt most comfortable. They said, “When you see their (people’s) surroundings you get a feel for what they like and who they are. People are more relaxed in their own homes and might say more. We just have a general chat, we might be subtle with the questions, so we can see what is understood.” A visitor told us about their friends admission to Haviland House and said, “When [person] came here I completed the care plan with [staff member], it was 20 odd pages but they captured everything.” People had brought items from their homes which provided some familiarity. A relative said, “[Person] has pictures of themselves on the walls. They have their jewellery and their own table and chair.” Nationally recognised tools were used to determine risks to people’s health, such as, the Waterlow tool which identifies risks of skin integrity deterioration. We saw care was planned in response to the outcomes, for example, people were given pressure relieving equipment and staff were directed to support people to reposition to prevent pressure sores.

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. Members of the management team had conducted research on how to best support people living with dementia. They utilised strategies to recognise and respond to changes in people’s demeanour, such as, PINCHME (Pain, Infection, Nutrition, Constipation, Hydration, Medication, and Environment). People were assessed using this tool, outcomes were monitored and if needed referrals to professionals were made. Staff further used the VERA (Validation, Emotion, Reassurance, Activity) framework when supporting people living with dementia, staff gave examples of where this had aided communication and their understanding of people’s needs.

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. Staff quickly and appropriately referred people to health and social care professionals to promote good outcomes for them. A visiting healthcare professional told us, “I have noted that when I have given advice and guidance for individual residents, the staff have followed these recommendations well. If they have any queries or wish to discuss further I find that the staff seem comfortable to question advice to ensure they are following latest guidance and protocols. All staff happily report updates to [member of management team] or myself and are usually able to answer all my questions when following up their residents.”

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’s nutrition and hydration needs were assessed and dietary needs were well documented. The catering team were an outsourced company contracted to provide a service to Haviland House, they commented on how well staff communicated with them to ensure meals were provided in line with needs and preferences. When needed, people had been assessed by relevant healthcare professionals, such as the speech and language therapists (SaLT). We saw SaLT advice was followed and a person’s food had been prepared to a specific consistency to avoid choking, the advice was clearly documented in care records. People told us they enjoyed the food and we observed the same. One person said, “The food is usually very good, we have choices, usually a lot of choices, if you don't like something there's always something to have.” A member of staff told us how the dining experience had been recently improved following an audit, this was to create a relaxed environment for people and for everyone to have the opportunity to go to the dining areas regardless of barriers to their mobility and needs.

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 monitored people on a day to day basis to ensure the care and treatment they were receiving was achieving the desired outcomes. A relative told us how their loved one had experienced a health condition; staff had monitored their bowel actions and fedback to professionals who reduced medicines, this had provided a positive outcome for the person. We reviewed charts and progress notes and saw staff were accurately recording people’s bowel movements, and food and fluid intake. People’s weights were monitored and any ongoing concerns were escalated to healthcare professionals. People’s reactions to support informed care planning to either change or continue approaches. For example, staff noted a positive improvement to a person’s mood and engagement when dogs visited, they made efforts to ensure when pets were in the service the person had time to engage with them.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Consent forms were in place, including consent to receive personal care, these forms were completed by people or, when needed, their legal representative. The provider made sure people and their relatives were fully informed about decisions, for example, the acoustic monitoring system was clearly explained through meetings and information was sent to people/and or their representatives. The provider ensured people were able to withdraw their consent at any time. When people lacked capacity to make decisions, mental capacity assessments were undertaken for specific decisions and best interest meetings were clearly documented. We saw staff asked people for permission to support them throughout our visit and respected people’s right to decline.