Acer Mews

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• 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. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Assessments and risk assessments were in place and being reviewed. However, we found some shortfalls in the completion of risk assessments, with information not being fully completed meaning that people’s levels of risk may not have been accurately reflected. We noted improvements were being made. One member of staff commented, “I try and involve care staff. The more you know about the resident the easier it is to assess their needs. I feel we could do more with the care plans and want staff to be more involved in risk assessments The carers know people well.” Staff had a good understating of people and told us that information about people’s changing needs was communicated with them.

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.

People were supported generally in line with their assessed needs. However, it was not always clear people were having the level of personal care and oral care support needed as records were not being fully maintained.

Information about people’s diet and fluid intake was not always clearly maintained. People had mixed views about how they were supported with food. One person commented, “Sometimes the food is spot on nice, but other times its horrible.” Another person commented, “It’s always chicken. There should be a bit more variation and salads and things like that, especially now it’s getting warmer.” The kitchen staff told us they tried to seek feedback from people and relatives and provide food in line with preferences where budgets allowed.

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 told us that there had been some recent improvements and they felt the team were working better together now. We observed staff supported each other across the unit when this was needed. One staff member commented, “I feel we are a good team. We are very flexible. It is a nice team to work with.” Another staff member commented, “There is consistency of staff. The team tends to stay and more often than not we have a good shift supporting people.” A relative stated, “It’s okay, better now than it was at first as all the staff were learning. The staff are very helpful and pleasant.”

Staff completed training in areas identified as necessary for the service, such as training to support people with a tracheostomy. Systems for regular supervision and appraisals were in place and had improved since the new registered manager commenced. Staff told us they had generally felt well supported and told us, “They offer bespoke training.” Another staff member told us, “The training is excellent.” A wider range of training was available for staff with additional face to face training being provided in areas of care reflective of the needs of people the home were supporting.

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 understood people’s needs and were able to recognise signs that people were becoming unwell. Staff supported people to access health care services and this advice was generally incorporated within people’s care records. However, not all detail of information, such as a recommendation from the speech and language team was fully incorporated into care records to ensure staff knew exactly how to safely support people in that area.

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.

Systems were in place to ensure care was begin delivered in line with people’s assessed needs. However, records did not always reflect care was being delivered in line with this, as care records were not always fully completed. For example, we found one person who required staff full assistance had only had a record of support with oral care on three occasions over the course of a week.

A member of the management team told us they had made some recent changes to make sure things happened at set times. They told us, “I can see things are improving and this is leading to improvements in the resident’s health.”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Accurate information about consent was not always clearly recorded in people’s care records. Whilst some people had consent forms completed it was not always clear what had been consented to. The provider was responsive to address these issues and to take steps to ensure accurate records of consent were in place.

Care records contained some information about mental capacity and best interest decisions but did not always include full records of those capacity assessments and best interest decisions. The provider assured us that these had been completed and would ensure they were uploaded within the system. Where people had conditions on their DoLS (Deprivation of Liberty Safeguards) it was not always clear these had been actioned.