Archived: Adelaide House Residential 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.At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 generally made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Some improvements were required when people’s assessed needs were reviewed.

People’s assessments identified their medical history, what physical assistance and well-being support they wanted and if other people had legal authority to make decisions on their behalf. Staff also considered people’s mobility, infectious status, communication and sensory needs as part of the assessment process. Where initial information about people’s needs and preferences had been received from “trusted assessors”, managers carried out their own face to face assessments to ensure they could provide safe and effective care. One senior member of staff told us people’s needs were reassessed after a hospital admission. They explained, “If they have been in hospital for longer than 3 days we like to go out and do another assessment to make sure their needs have not changed.”

Staff told us the assessments undertaken by senior staff provided them with the information they needed to provide good care to people from the point they began to use the service. A health and social care professional who regularly visited the home told us if staff had any doubts about their ability to meet people’s needs, they sought their advice and acted accordingly.

People's needs were reassessed as they changed. However, monthly reviews of assessments had not identified information about changes was not always reflected in all areas of people’s care plans. This meant there was a risk of inconsistencies in the support people received.

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 encouraged and supported people to have enough to drink and offered them choices and responded to people’s requests. Where people needed support from staff to eat their meals, staff maintained good eye contact with people, worked at their pace and listened to any preferences they had. People raised no concerns about the food or the range of food options available to them. One person told us, “The food is wonderful, nice and tasty and we do get plenty.”

Where people required specific types of diet to help them maintain their long-term health conditions, this was recorded in their care plans. Care plans also confirmed people’s food and drink preferences and whether their meals and snacks needed to be fortified.

Catering staff knew which people required specific texture of food and the reasons why. They described a good flow of information from care staff as people were admitted to the home or their nutritional needs changed.

Where staff had concerns that people may not be eating enough to remain well, they regularly monitored people’s weight. Staff took action to support people at risk of malnutrition by seeking advice from other health and social care professionals.

The provider worked well across teams and services to support people.

Care staff knew what support people needed to maintain their health. Staff regularly worked with other health and social care professionals, so people would have access to the care they needed, such as GPs, the frailty nurse and speech and language therapists. Staff were confident senior staff would take prompt action to obtain help from other health and social care professionals when people wanted or needed this. This included assistance from district nurses so people would maintain their skin health and from emergency services, if someone needed immediate assistance. One staff member told us, “We have a really good relationship with the GP surgery. If something happens at 4.00pm, I will phone the GP, and they would come out that day.” A visiting health and social care professional told us, “[Registered manger and deputy manager] are willing to learn and take advice from me and translate this into practice. They are keen to improve.” This healthcare professional told us staff checked people’s vital signs and passed this information to professionals, to share information effectively when they had concerns about people.

One person told us they experienced a longstanding health problem. The person told us they could rely on staff to seek assistance from district nurses and said they saw them regularly. The person said staff also helped them to maintain their skin health by applying creams as prescribed.

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.

Where people had specific health needs, such as a pressure sore, advice from other health and social care professionals had been sought and appropriate equipment put in place to support them. For example, air flow mattresses and pressure relieving equipment. People were supported to have vaccinations and attend healthcare appointments to promote their continued health.

A visiting health and social care professional told us staff promptly made referrals to them. The health and social care professional said, “[Registered manager] has usually already started what I would suggest they do, and they are hot on getting antibiotics and getting them administered.” This helped people to quickly recover their health.

The provider did not always routinely monitor people’s care and treatment to continuously improve it.

Records were not always completed accurately or contemporaneously to demonstrate safe practice and enable effective monitoring to take place. For example, there were limited entries or information on food and fluid intake charts, fluid output charts for people with a catheter and repositioning charts for people at risk of skin damage. Although records did not evidence care was being provided in accordance with people’s care plans, we did not identify any detrimental impact on people. The registered manager told us they would urgently review their processes to improve their oversight of daily records and ensure effective monitoring of people’s care.

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

Staff understood the importance of listening to people’s wishes and respecting these. One staff member told us if a person declined elements of their care, they would talk to the person and try to offer the care later. If the person continued to decline, they would alert a senior member of staff or their manager. The staff member said, “Sometimes you need to leave it. We cannot [provide care] without permission.”

Records demonstrated people’s consent to individual areas of care and specific decisions had been considered. This included in relation to the sharing of information, Covid testing and vaccination. Where people with capacity had made decisions with risk, the provider respected people’s right to make these decisions. Where people did not have capacity to make a specific decision, relatives were consulted and involved in making decisions in people’s best interests. Staff considered if any other person had the legal right to make decisions on behalf of people.

Where people had restrictions in their care plans they did not have capacity to consent to, the provider had submitted applications for a DoLS (Deprivation of Liberty Safeguards) to the authorising authority. Nobody had any conditions on their authorised DoLS at the time of our inspection.