Dickley Court

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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 had their needs assessed before accessing the service. These assessments were used to develop the person’s care plans and make the decisions about the staffing hours and skills needed to support the person. The assessment included making sure that support was planned for people’s diversity needs, such as their religion, gender, marital status, culture and their abilities.

Assessments included information about what people could do for themselves. Each person’s care plan and assessments were also reviewed prior to each stay. This ensured that every person’s care plan and risk assessment were updated to ensure the care they received met their needs. Staff explained people were offered trial stays before they came to the service. A staff member said, “They do taster sessions for new service users, when they are ready they then have an overnight stay.”

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.

Care plans and risk assessments clearly described what modified diet people were prescribed and the care plans followed The International Dysphagia Diet Standardisation Initiative (IDDSI) framework. The guidance was also available in the kitchen for staff responsible for preparing, cooking and serving meals. Staff had a good understanding of people’s assessed needs in relation to type and texture of food as well as any allergies and food intolerances. Staff told us they helped people to make their meal choices if they needed it.

We observed food in place to meet people’s dietary needs and religious needs. Staff told us they supported people to be involved with the preparation and cooking of meals which also enabled people to develop new skills. Staff said, “We meet people’s dietary needs, such as Sikh and Muslim. We are aware of allergies and provide gluten free diets. We cook from scratch. [Staff member] does the meal planners and works this around people’s dietary needs.” They explained that a person was not eating vegetables before and now they were eating vegetables because they were enabled to prepare and cook foods in the kitchen. People told us they liked the food. We observed people were given choices of food.

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 had a clear process in place to escalate health concerns within a timely manner. Staff worked with health professionals to ensure people got the care and support they needed. A health professional told us, “This service typically communicates with me relating to my ongoing assessment and intervention related to behaviours and activity engagement. This service stood out in their ability to cooperate with my request for behavioural data when required.”

The registered manager and staff told us, there were good links with other health professionals such as SaLT (Speech and Language Therapy), physiotherapy and social workers. Relatives told us staff accessed medical help when required.

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.

Relatives told us their loved ones were supported with their healthcare if needed when they had a stay within the respite service.

People staying at the service had access to visiting health care professionals, for example, dietician and SALT (Speech and language therapists). People were supported to attend medical appointments if they were needed. Staff had a good understanding of meeting people’s changing needs. A staff member told us, “We support with medical appointments, I have supported with hospital appointments for example if a person has an unusual seizure. We do temperature checks if people are feeling unwell, if they have a high temperature we try and send them home, so we don’t have things like flu spreading.”

We observed staff supporting people to maximise their independence, providing lots of praise and providing reassurances. We observed that plenty of fluids were offered to people to keep them hydrated and in good health.

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.

Staff worked together as a team to support people and to ensure people received their care and support in the way they chose. People were referred on to health care professionals when this was required, referrals had been completed in a timely manner. Equipment was used to support people’s health monitoring such as epilepsy sensors.

A relative told us, “They have been happy to ask for reassurance on how to set up the seizure monitor under the mattress and make a video about how to do it, this is reassuring for us that the staff are happy to ask about it and not just read it in the file.”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. We checked whether the service was working within the principles of the Mental Capacity Act (MCA), whether appropriate legal authorisations were in place when needed to deprive a person of their liberty. The service did not always work within the principles of the MCA. Consent forms seen within care records had been signed by relatives rather than the people who were using the service. There was no record of capacity assessments to show that the person lacked capacity to make the decisions. Therefore, the principles of the MCA were not always followed.

We observed people making everyday choices and decisions about their lives during their stay, such as what they wanted to eat, drink, what activities they wanted to do. Relatives told us staff respected their loved one’s choices. Staff had a good understanding of consent. A staff member said, “Sometimes people don’t want to be there, we try lots of activities and give lots of choices to see if they will settle, if they remain unsettled I would check if they are in pain, we may have to call the parent.”