Housing 21 - The Watermill

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• 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 75 (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 needs were assessed prior to them moving into the home and information gathered was used to create care plans and risk assessments which directed staff in terms of how to meet people’s needs.

Staff told us, and records confirmed, where people stayed at the home for respite, or a short-term stay, information was not always as comprehensive as it could be. We discussed this with the registered manager who told us they had recognised that due to the short notice received for respite stays, referral information was sometimes minimal. They told us they had introduced a system which involved a discussion with the person, or a call to relatives, to try and gather further information about the person’s needs and preferences.

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.

The management team worked with external agencies, such as healthcare partners to ensure people’s care was supported by best practice guidance. This included guidance within care plans relating to people’s mobility or nutritional needs. Staff sought specialist advice to ensure practices were current and positive for people. This included working with GP’s, occupational therapists and social workers. Risks to people’s health and wellbeing were assessed and monitored using recognised tools, including for pressure care and nutrition.

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.

Relatives told us information was shared with them and they were kept up to date with any changes. One relative said, “I do feel involved in everything.” Relatives were invited to annual reviews to review people’s needs and give families an opportunity to share their feedback about the care people received. Communication with partner agencies was positive and the staff team worked directly with external professionals who supported people’s needs, such as GPs and care management teams.

Information was shared across the staff team about people’s needs and any changes in their health or wellbeing. Staff told us they reviewed people’s daily records and also received handover information so they knew to be aware of any new risks or concerns.

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 staff were responsive to people’s changing health needs and contacted relevant professionals for support when required. One relative commented, “The Doctor comes in here if she needs medical help.”

The staff team supported people to maintain their health. This included monitoring people’s health, including their intake of food and drinks. One staff member told us, “We do the charts, what they have to eat throughout the day, we put refused or what they have had, 200mls for example. Some people are at risk of not eating and drinking enough.”

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.

Relatives shared how the care people received had a positive impact on their health and wellbeing. One relative said, “The difference in [person] since coming here is immeasurable. She is eating better and she is happier and more content. She is eating more and has gained weight here.”

Staff recorded information that was essential for the monitoring of their health and well-being. These observations and records enabled staff and the management team to take timely action where there were changes to people’s health or well-being. Care plans were then updated to ensure support was provided that met people’s current needs.

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

People told us they were asked for their consent before care was provided. We observed staff checking in with people about whether they were happy to be supported with personal care, as well as other aspects of their day, such as where they spent their time and what they ate and drank. One person told us, “I make all of my own decisions. I just go to bed when I want. I just tell them I am going.”

Care plans contained clear information about people’s mental capacity to make specific decisions and staff understood people’s needs well. Where people lacked capacity to make specific decisions there was a formal process in place, involving relevant professionals and relatives, to ensure decisions were made in people’s best interests.