Appleby

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. This key question has been rated 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.

People’s needs were assessed so their needs and preferences could be met. Staff demonstrated a good understanding of people’s assessed needs and the assessment process. Staff used an electronic care planning and assessment system, which had been introduced recently, to record and review this information. We identified minor shortfalls in some people’s records in relation to wound care, nutritional needs and positional changes. There was no impact on people as a result of these shortfalls. The registered manager took immediate action to address 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 and relatives spoke positively about meals at the home. One relative told us, “They get a good choice of food and mum loves the food and finds it definitely acceptable.” We observed the mealtime experiences and saw that the meal in Grace Suite which was located on the ground floor was organised and provided promptly. Mealtimes upstairs in Laurel and Armstrong Suites were delayed. The registered manager responded quickly to our feedback. She paused non-essential duties so staff could prioritise supporting people. She also told us that she had ordered an additional food trolley to improve efficiency upstairs.

Staff 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.

A handover system was in place to make sure essential information was passed between shifts, which supported continuity of care. ‘Huddle’ meetings also took place to enable staff to share updates, discuss any immediate issues and maintain consistent, joined‑up support.

Staff supported people to manage their health and wellbeing to maximise independence, choice and control. People were supported to see health and social care professionals to meet their needs. Professionals spoke positively about the care provided. One professional told us that staff acted promptly and sent referrals before issues became urgent.

Staff 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. This included monitoring and supporting people’s specific health conditions, such as diabetes management and mental health needs, to ensure care was tailored and responsive to individual requirements.

Health and social care professionals spoke positively about the home. One professional told us how staff were open to exploring a range of approaches to support people who displayed distressed behaviours. This included considering psychosocial strategies alongside medication options to help ensure that care was person-centred.

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

DoLS applications had been submitted to the local authority for authorisation, in line with legal requirements.