Scarlet 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 Good. At this assessment the rating has changed to Outstanding.

This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 96 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff had a consistent and high-quality approach to assessing, and reviewing people’s health, care, wellbeing and communication needs with them. For example, the service had person-centred care plans which detailed people’s care needs extremely well and were personal to them. One care plan referenced using best practice tools, such as malnutrition assessments, assessments for skin integrity, and pain scales for when people could not verbalise if they were in pain. Care plans used language which was person-centred and described people should have food which was ‘nourishing and enjoyable’. Care plans captured people’s histories, goals, likes, dislikes and preferences.

Care plans signposted staff to other documents to ensure continuity. Staff told us they had time to read the care plans and were very knowledgeable about people’s needs, preferences and any specifically individual information about them. For example, 1 staff member told us how the care plan informed them about strategies to use when supporting someone who could become anxious quickly. People were involved in reviewing their care records where appropriate and relatives told us they had access to care plans and had regular discussions with staff.

People benefitted from having care plans which read more like biographies rather than clinical notes, and staff used these to have positive impact on people’s daily living.

The provider always 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. They worked to develop evidence-based good practice and standards.

Staff delivered care in line with recognised best practice for supporting people living with dementia, adapting their approach to meet individual needs. They demonstrated a strong understanding people may respond differently to care and adjusted their approach based on what was most effective for each person. For example, staff described how they identified when a person became overwhelmed during personal care and explored underlying causes, including unmet needs and communication difficulties. Staff adapted their approach using personalised communication, reassurance and techniques such as singing, which helped reduce distress and enabled the person to be supported more effectively, resulting in a calmer experience and better engagement with care.

People who were on modified diets had access to snacks in the café which were appropriate for them without having to ask staff specifically for them. The provider worked to ensure people did not experience barriers to receiving nutrition and hydration even if they were on modified diets. Foods were modified to look appealing while still being safe and appeared the same as food which was not modified. The service had hydration stations located throughout the different floors and units, as well as snacks. Staff told us they always encouraged people to drink by having a drink with them and staff were encouraged on all units to eat with people to support them to have adequate nutrition. These were seen as opportunities to engage with people, rather than as tasks. We observed people eating most of their meals as staff were sitting with them and gently encouraging them as they shared the meal.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

There was a commitment and a culture of working collaboratively and staff and teams had found innovative and efficient ways to deliver more joined-up care and support to people. Staff worked with people and relatives to learn what was most important to people. For example, 1 person was celebrating a significant birthday, and staff had learned they enjoyed a specific brand of ice cream, the team worked together to bring this in as a surprise for them. A staff member told us, “This was a meaningful and achievable wish. We know the importance of acting on the small details that matter to people.”

People from other Care UK services and other nearby care homes were often invited into the service for special activity days.

The activity team had specialist training to deliver a unique activity called ‘balls of energy’ which the service opened to the wider community to promote engagement. Staff told us, “It’s so popular we take bookings over the phone.”

The provider also hosted external organisations to hold their meetings at the service, this enabled people to learn about organisations in their local area and explore new opportunities.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

There was a strong focus on empowering people to maximise opportunities to manage their own health, care and wellbeing needs as much as possible. Staff fully understood people’s needs, preferences and abilities, which enabled them to identify and aid as many opportunities as possible for people to be independent. The service had a weekly meeting involving the GP, community nurses, pharmacist, unit managers, nurses and other professionals as appropriate to have co-ordinated meetings where people’s needs were discussed. Actions could be commenced in a very short space of time and people were not waiting for clinical support. This had led to a reduction in hospital admissions and unplanned transfers.

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

Feedback from relatives demonstrated clear improvements in people’s health and wellbeing. Relatives described significant changes since their family members had moved into the service. A relative told us, “[Relative] has improved so much since being here. Their [medical condition] is much more stable than before. Staff really know what works for them.”

Standardised tools and documentation had been introduced to support person-centred care and consistent practice. These included exceptionally detailed life histories in people’s care plans, which helped staff understand people’s backgrounds and what was important to them. Assessments were completed to ensure people received the right level of support based on their abilities.

The service used systems to monitor and improve practice, including audits and assessments to measure people’s quality of life, which helped track progress in improving outcomes. Observations showed people were engaged, content and actively participating, demonstrating positive outcomes and meaningful improvements in their day-to-day experiences.

Staff had developed their knowledge through training and engagement with dementia specialists, supporting them to better understand people’s needs and adapt care approaches to improve wellbeing. The unit manager of the specialist dementia unit told us they were supported with a robust training programme through the provider and often went to other care homes to share ideas and areas of good practice.

Staff described the impact of care on both people and their families, with 1 staff member stating, “One person is now on reduced medication after 2 years here.”

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

People received information about care and treatment in a way which they could understand and had appropriate support and time to make decisions. People told us staff respected their privacy and dignity and observations confirmed this. For example, staff knocked on people’s doors before entering, they ensured people and visitors had access to private areas if they wished and staff asked people’s opinions on their preferences for food, clothing and activities.