Cuttlebrook Hall

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 79 (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’s care needs were thoroughly assessed and regularly reviewed through the provider’s resident of the day process, which ensured assessments were kept up to date and reflective of people’s changing needs. People were actively involved in these assessments, contributing to discussions about their care and making choices about how they wished to be supported. Care documentation was detailed and covered all key areas, including people’s physical, mental and social needs. One relative told us, “[Person] was resident of the day recently and we were pleasantly surprised when they rang us up to tell us and talk through the package of what that involved.”

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 had individualised care plans created in partnership with them and those important to them. These plans were developed following initial assessments and updated whenever new risks were identified, after changes in needs, or following any accidents or incidents. Risk assessments were completed when a person moved into the home and reviewed monthly when the person was resident of the day. Care plans were tailored to each person and included detailed information about health needs, personal history, preferences, and people important to them.

The provider identified that one person had started walking the corridors late at night. Staff recognised this behaviour was linked to the person feeling hungry. In response, the registered manager arranged for a snack trolley to be taken to the unit each evening. Once this was put in place, the person stopped walking at night. This demonstrated staff’s ability to identify underlying causes of behaviour and implement simple, person centred solutions that improved the person’s wellbeing.

One person moved into the home while experiencing delirium and was initially supported in a higher dependency unit. Staff focused on meeting the person’s nutrition and hydration needs, offering regular support, reassurance and close monitoring. Over time, the person’s delirium reduced and they became less confused. As their needs changed, the person was able to move out of a higher dependency unit and into a unit more appropriate for their needs. They became more physically able, their walking ability improved and the medication they were prescribed was reduced. This showed that staff monitored people’s changing needs effectively and adapted care in a responsive, person centred way to support improvements in health and wellbeing.

In addition, the provider used recognised clinical tools to monitor people’s health and wellbeing, incorporating these into care plans and risk assessments. For example, staff used the Malnutrition Universal Screening Tool (MUST) to identify individuals at risk of malnutrition, enabling timely interventions and support to maintain nutrition and improve overall health outcomes.

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.

The provider worked closely with healthcare professionals, including the GP. The registered manager told us the GP visited the home weekly, and a meeting was held to discuss any people who required medical support or review. The registered manager usually attended these meetings, however, other senior staff were also able to attend in their absence to ensure continuity of communication. This supported effective partnership working and ensured people’s health needs were monitored and responded to in a timely way.

The provider worked closely with the care home support team, who facilitated referrals to other healthcare professionals such as physiotherapists and district nurses. This partnership approach enabled people to access timely specialist support.

Staff told us they worked well together, “I find in the past year I have worked there, the staff have become a stronger team and work well together to get all tasks done, the team leaders are happy to help on the floor if required.” During the inspection we observed staffing working well together.

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.

One person living at the home expressed a wish to walk to the café independently. Staff supported them to achieve this by focusing on improving their overall health and wellbeing. They encouraged the person to review their nutrition and improve their nutritional intake to support healthy living. Staff also worked with the person to build stamina by supporting them to attend exercise classes held within the home, helping them gradually improve their strength, mobility and confidence. As a result, the person’s stamina increased significantly, and they were able to walk to the café independently. This showed the provider’s commitment to helping people lead healthier lives by promoting good nutrition, physical activity and independence in a person centred way.

People were encouraged to spend time in the garden to support their wellbeing and promote healthier, more active lifestyles. Staff supported people to take part in meaningful outdoor activities, such as planting and maintaining the garden. For example, one person was actively involved in planting and tending to the borders. The garden included raised borders designed specifically to ensure people could access them safely, enabling individuals with reduced mobility to participate fully. The home had a weekly walking group which is well attended.

The provider offered a variety of weekly exercise classes to support people to live healthier and more active lives. The programme included seated exercise sessions, boxercise and seated stretch and pilates classes. The provider told us they had arranged for staff to receive specific training so they could safely deliver the seated exercise class. An external instructor also visited the home to facilitate some of the sessions, providing additional expertise and variety. During the inspection, we observed the boxercise class was well attended. Staff ensured the room was set up in an accessible way so people could participate safely and comfortably.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

The provider actively monitored all aspects of people’s care and treatment to drive continuous improvement. Outcomes were consistently positive and aligned with both clinical standards and the expectations of people themselves. Staff and management participated in daily management meetings where any changes in health or wellbeing were discussed, recorded, and acted upon.

Relatives confirmed that staff identified and responded promptly to changes in their family members’ health. One relative told us, “If [person] has been a bit more confused than normal they’ve been more active with taking urine examples. They do hourly checks on [person] to, which is what I would want.”

Monitoring charts, such as welfare checks and food and fluid records, were consistently completed and kept up to date. People’s weights were monitored monthly, and where concerns

were identified this frequency increased to weekly to ensure any risks were identified and managed promptly. Nutritional and hydration needs were assessed and met through appropriate care planning and ongoing reviews. The provider also used a clinical risk tracker, which included key information such as people’s weights, risks of skin breakdown and prescribed medications. This was reviewed and updated monthly, enabling the provider to monitor changes in people’s risks, outcomes and needs over time. These processes supported effective oversight of people’s health and ensured emerging concerns were recognised and acted on without delay.

The provider shared several examples of how they supported people to achieve positive outcomes that significantly improved their quality of life. For example, 1 person was very anxious and nervous when they first moved into the home and had difficulty settling. They found socialising challenging and spent most of their time in their room. Staff took time to get to know the person’s interests and hobbies and developed personalised activities based on what they enjoyed. Although the person did not want to join group activities, they were willing to engage in 1 to 1 sessions with staff. The provider purchased a watercolour painting kit for the person after researching that water colouring can be calming and therapeutic. The person began using the watercolours and started sitting in the café area while painting, initially not wanting to socialise. Over time, their confidence grew, and they developed a social network. They now welcome new residents into the home and share ideas and suggestions with staff about activities that could be added to the schedule. This demonstrated a personalised, patient and responsive approach that enabled the person to overcome anxiety, build confidence and participate in meaningfully activities.

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

The provider worked within the principles of the Mental Capacity Act 2005 (MCA). The 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 make 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 Mental Capacity Act (MCA).

Where people required assistive technology to maintain their safety, we found best interest meetings had been recorded to demonstrate decision making. For example, some people required falls sensors to reduce the risk of them falling. Mental capacity assessments and best interest decisions had been completed, along with rationale on why the least restrictive option was decided.

We observed staff knocking on doors before entering people’s rooms. Staff told us, “I would always explain what I’m doing and ask for consent.”