Old Hastings 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.

This meant people’s outcomes were consistently good, and people’s feedback confirmed
this.
At our last assessment we rated this key question good. At this assessment the rating has remained good.

This service scored 67 (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. Before moving to the service, a pre-assessment was carried out by a senior member of staff or manager. These were detailed and covered all known risks to people and their needs were assessed to ensure that the service had the right staff with the right skills to be able to support them. The notes from these meetings went on to form the basis of care plans when people moved into the service. Some care plans lacked detail however the registered manager knew this and was in the process of updating these documents. People and their relatives told us they were involved in the pre-assessment process, comments including, “Yes I have been involved all the way as the care is very complicated” and “Yes the pre assessment was good we had a meeting and went through a long form and asked questions and gave information.” Similarly, relatives told us they were present and could contribute to ongoing reviews of care, one telling us, “The new key worker seems to make a lot of effort. I think I will be more involved moving forward. They always tend to ask what I think should be done rather than what they think should be done.” The registered manager told us that all new residents were visited in their rooms by the managers on their first day and were reviewed monthly thereafter.

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. Staff knew people well. A key worker system ran at the service with staff being responsible for a small group of people, attending to all of their needs not only their day to day care and support. A staff member told us that they updated care plans as people’s needs altered and would bring significant changes to the attention of supervisors. They went on to tell us they spent time with people when carrying out reviews and that people were very much involved in contributing to their own care plans. This resulted in positive outcomes for people as staff were able to detect the slightest changes in people’s presentation and needs. Despite this there were gaps in some people’s care plans. See our well led section for more on documentation.

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. A team of cooks provided a seasonal four-week menu and were aware of people’s dietary needs and requirements. A clear chart on the wall of the kitchen showed allergies, likes, dislikes and special requirements for example those living with diabetes or requiring a soft diet. People and their relatives spoke positively about the food. Comments included, “Yes, it is always well prepared and there is always choice, they always meet (relatives) requests” and “Mum always says it’s very good, they always come in with a menu and explain the choices. It seems varied and nutritional.” The kitchen was clean and well equipped. Temperature checks of food and equipment were carried out and recorded. We saw staff supporting people during mealtimes, offering to cut up food, speaking kindly to people and making them feel comfortable.

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. A team of cooks provided a seasonal four-week menu and were aware of people’s dietary needs and requirements. A clear chart on the wall of the kitchen showed allergies, likes, dislikes and special requirements for example those living with diabetes or requiring a soft diet. People and their relatives spoke positively about the food. Comments included, “Yes, it is always well prepared and there is always choice, they always meet (relatives) requests” and “Mum always says it’s very good, they always come in with a menu and explain the choices. It seems varied and nutritional.” The kitchen was clean and well equipped. Temperature checks of food and equipment were carried out and recorded. We saw staff supporting people during mealtimes, offering to cut up food, speaking kindly to people and making them feel comfortable.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. People’s records contained a decision making care plan, however mental capacity assessments were sometimes incomplete, not recently reviewed or were absent. Some records recorded diagnosis of Alzheimer’s disease but neither the condition nor people’s capacity to continue to make decisions had been reviewed for two years. Other records said that ‘large scale’ decisions were made by family members, ‘in their best interests.’ For example, lists of foods that people can eat. The person was unaware of the lists and there were no records found of best interest meetings having taken place. Similarly, Deprivation of Liberty Safeguards (DoLS), restrictive measures put in place to safeguard people unable to make specific decisions, were in place for some people but again had not been reviewed and people had not always been consulted. For example, the use of sensor mats. No records were found of discussions with people. Also people living in a section of the service that required a code to pass through a door. Not everyone’s care plans had details of this restrictive practice. People’s views about consent were mixed. One person told us, “I signed my consent when I came in, not sure I have discussed it since.” A relative added, “Yes, they have Alzheimer’s however they are very diligent in trying to fulfil their wishes.” Despite most staff being out of date with dementia training they did understand the importance of gaining consent from people before carrying out a task or activity. We saw staff engaging with people living with dementia and taking their time to explain what was happening and talking with them in a kind, compassionate way.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. People’s records contained a decision making care plan, however mental capacity assessments were sometimes incomplete, not recently reviewed or were absent. Some records recorded diagnosis of Alzheimer’s disease but neither the condition nor people’s capacity to continue to make decisions had been reviewed for two years. Other records said that ‘large scale’ decisions were made by family members, ‘in their best interests.’ For example, lists of foods that people can eat. The person was unaware of the lists and there were no records found of best interest meetings having taken place. Similarly, Deprivation of Liberty Safeguards (DoLS), restrictive measures put in place to safeguard people unable to make specific decisions, were in place for some people but again had not been reviewed and people had not always been consulted. For example, the use of sensor mats. No records were found of discussions with people. Also people living in a section of the service that required a code to pass through a door. Not everyone’s care plans had details of this restrictive practice. People’s views about consent were mixed. One person told us, “I signed my consent when I came in, not sure I have discussed it since.” A relative added, “Yes, they have Alzheimer’s however they are very diligent in trying to fulfil their wishes.” Despite most staff being out of date with dementia training they did understand the importance of gaining consent from people before carrying out a task or activity. We saw staff engaging with people living with dementia and taking their time to explain what was happening and talking with them in a kind, compassionate way.