Archived: Squires Mews 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 Squires Mews Care Home since it was registered. 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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People and their relatives told us they were actively involved in assessments, planning and reviewing their care to ensure they received person-centred support. People’s needs were assessed before they moved into the care home. A person told us,“Initially I moved here for a short stay. They asked lots of questions about what help I needed and what I could still do for myself. Now this is my home for the rest of my life.” Relatives told us they supported their family member in the assessment and care planning process to ensure their preferences and decisions made were documented.

Initial assessments were comprehensive and clear covering all aspects of the person and the care they required. Care plans were developed from these assessments outlining how staff were to provide support to meet their care needs. These were regularly reviewed to ensure guidance continually reflected people’s current needs. Staff knew how to access people’s care plans on the care system. Staff had good knowledge about people’s needs and documented the support provided.

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.

Management team and staff used recognised clinical assessment tools to assess and monitor people’s needs such as skin care, dietary and hydration needs. These included the malnutrition universal screening tool (MUST), and tools to assess falls and frailty. Staff worked with speech and language therapy team to ensure people’s dietary requirements were met. People’s care plans contained clear instructions for staff to follow. Appropriate observations were carried out when people presented as unwell and staff referred people to relevant health professionals quickly, and they followed their advice.

People told us they received care and support that enabled them to live as they want to. A relative said, “From what I see I wouldn’t have any concerns about the staffs skills, they are aware of what residents needs are. They take time over people; they check [Person’s] alright. [Person] says [staff] are lovely.” The chef and kitchen staff were knowledgeable about people’s dietary requirements such as religious or medical needs. Care plans included nutritional information about the modified textured diets and the support a person required with eating and drinking. Records showed dietary needs were met.

The mealtime experiences we observed was positive. The dining tables were laid with a tablecloth, cutlery and condiments. The meal of choice was served quickly by staff, were well-presented and looked appetising including modified meals. We saw staff supported people to eat where needed. People and relatives views about the quality and food choices were mixed. We shared the feedback received with the registered manager. They assured us there was ongoing action being taken to improve the quality and variety of meals offered, in response to feedback received from people.

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.

People were supported by staff that worked well together and with health care professionals and services. This ensured there was a joined up, consistent and effective approach to meeting people’s individual care needs.Staff made referrals to external health and social care professionals for assessment and advice when people’s needs changed. Recommendations made were implemented and communicated with the staff team. Staff told us communication was good, and information about people’s needs was shared promptly internally and with external health care professionals when required. A visiting health professional told us, “Staff are very good, they follow instructions for wound care and do all the blood sugar checks before we come. They know their patients.”

People told us staff supported them as needed. A relative told us, “[Person] changed surgeries to the one affiliated to the home and they see a doctor when necessary.”

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 were seen by health care professionals when they needed them. People’s care plans contained scheduled appointments and any specific support people needed to attend these. Staff told us communication was good, for instance daily handovers included new information and instructions to meet people’s needs. Staff monitored people’s health for changes and deterioration. For example, food and fluid intake and weight loss or gain was monitored which helped to detect early signs of deterioration. A visiting health professional told us the management team and staff were knowledgeable about the people they cared for.

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.

Systems and processes were in place that monitored clinical care outcomes. These were underpinned with policies and procedures for responding to changes in people’s health. Staff we spoke with understood their responsibilities and the action required. People’s care records contained all care interventions, which enabled the deputy manager and the clinical lead to identify changes in people’s care and health needs. There was evidence of regular reviews and action being taken immediately following any changes to people’s health needs. For example, records for fluid taken and urine output for a person with a catheter was monitored to ensure the individual had enough to drink. A relative said, “My [person] has had no falls since being at Squires Mews, they even jig-around dancing.”

During our visit we observed a nurse and staff were monitoring a person’s health. When staff identified clinical deterioration the emergency service was contacted immediately. The staff member had not completed the care notes immediately due to the person’s rapid decline in health and they were aware of this. There was no impact on the person as the same staff team were monitoring this person’s health. This was shared with the registered manager and provider, and they assured us action would be taken, and all staff would be reminded to record care interventions promptly.

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

People’s rights were respected. People told us staff sought their consent and respected their wishes. A person said, A relative said, “Staff asked if they could help me, they listen and never have to be told twice - you can tell they were experience staff.”

Staff had received training on the Mental Capacity Act (MCA) and were aware of the importance of supporting people to make their own decisions. A staff member said, “If someone is living with dementia they can still make some choices or decisions; maybe ask shorter questions and show them the options to choose from.” Staff were seen gaining consent before providing any care or support throughout our visit.

The registered manager and staff understood their responsibility under the MCA and Deprivation of Liberty Safeguards (DoLS). Management team ensured relatives, with the appropriate legal authority had been involved in making best interest decisions for their family member. Monitoring systems enabled the registered manager to ensure new applications and renewing DoLS authorisations were completed in a timely manner.