Whitstable 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 inadequate. 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. At our last inspection there were shortfalls in the assessment of people’s needs. At this inspection there had been significant improvements. People’s needs had been assessed and recorded within their care plans. People’s care plans included their choices and preferences with information about how these could be met.

Staff described people’s likes and dislikes including their previous hobbies and interests. The activities organisers understood what people liked to do and made sure they had access to activities. People told us they had been involved in deciding what equipment they used to mobilise safely including when they felt a ‘bit wobbly’, “I use my frame when I am unsteady but mainly my stick.”

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. There had been improvements in the way assessment tools were used to assess people’s needs. Staff had completed assessment tools such as Waterlow and Malnutrition Universal Screening Tool (MUST). These tools had been used to identify when people needed specific equipment such as a pressure relieving mattress or needed to be referred to a health professional.

Staff understood people’s needs around their diet and fluids. We observed people’s meals being prepared to their specific needs such as minced and moist. People’s preferences were known and catered for, such as a person’s preference for baked beans. Staff knew they would eat more of their meal if they had baked beans. People who were at risk of weight loss, had their diet and fluids recorded to monitor their intake and act if they were not eating enough.

The provider worked well across teams and services to support people. At our last inspection there were concerns staff and healthcare professionals did not always work well together. At this inspection there had been improvements. The registered manager had changed GP, and people were now registered with the surgery next to the service. The registered manager described how staff and the staff at the surgery had discussed how to work together and staff had attended training at the GP practice to understand the systems in place. The GP attended the service weekly to discuss people’s needs.

The registered manager understood their role in rebuilding relationships following the last inspection. They had spent time discussing with health professionals what was expected and when they wished to be involved. We identified situations where health professionals had been involved with people’s support, and this had benefitted them such as the assessment of people’s capacity.

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. Improvements have been made following our last inspection. People were supported to attend the GP surgery next to the service for treatment such as ear syringing. People had also gone across to have x-rays or attend specialist appointments.

Relatives told us, “People come in. The dentists are in to do check-ups. They are booked in. Yes, they let me know in advance that it’s going to happen, at least a week before.”

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. At our last inspection we found significant shortfalls, at this inspection improvements had been made. Relatives told us staff had recognised when their family member was not happy and made changes. They told us, “With my (relative), it’s much more difficult, because physically they are chairbound. What they like is looking at the view and not having too much loud activity around, which can be rather difficult in the main room. The TV can be quite loud and they don’t respond well to that. They have realised they like sitting in the staff office and they are often with the floor manager in the office, sitting quietly in there.”

The registered manager had identified with people what would improve their lives, this included examples such as spending time in the office helping staff and going out with staff. People confirmed they had been supported to go out and they helped in the office when they wanted.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. At our last inspection we identified significant shortfalls, staff were not working within the Mental Capacity Act 2005 (MCA) and had not followed best practice guidance. At this inspection there had been significant improvements, and this had improved people’s lives. Previously a person had been receiving 1:1 care with the sole purpose of stopping them leaving the building. The registered manager had discontinued this and worked with the person to design a system which kept them safe but enabled them to go out. The person told us they went out with staff when they wanted. The registered manager told us staff travelled on the bus with them to wherever they wanted to go including the bank and they kept their own bank card to do their shopping. The system worked well as staff were there more as a friend than carer.

The registered manager had reviewed people’s capacity assessments, where possible they had discussed people’s needs with them. When people appeared to have capacity though previous assessments and legal authorisations had stated they did not, the registered manager had organised for them to have a new assessment by a clinician. The new assessments had shown there were people who did have capacity, and their support had been reviewed. One person told us they were now back in charge and was very happy.