Wyndham Hall 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 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.

Staff completed a comprehensive assessment of each person’s physical and mental health prior to a person moving into the care home. People’s preferences were recorded and, where possible, taken into account. Care plans reflected a good understanding of people’s needs, including relevant assessments of people’s communication support and sensory needs.

People had care and support plans that were personalised, holistic, strengths-based and reflected their needs and aspirations, including their physical and mental health needs. Systems were in place to review care plans; however, we received feedback from some relatives they were not always included in reviews. We have discussed this with the registered manager to ensure reviews include all relevant parties.

Nursing staff used nationally recognised assessment tools to identify risk, for instance when assessing skin integrity. Systems were in place to ensure assessment of needs were reviewed when people’s needs changed.

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.

People’s nutrition and hydration needs were identified and managed in line with current guidance. The provider used recognised clinical tools to monitor people’s health and wellbeing, incorporating these into care plans and risk assessments. For example, staff used the Malnutrition Universal Screening Tool (MUST) to identify individuals at risk of malnutrition, enabling timely interventions and support to maintain nutrition and improve overall health outcomes. Clinical tools were reviewed on a regular basis.

People living with dementia, benefited from an environment which was regularly checked to ensure if followed best practice guidance. We noted many interactive opportunities were
available for people living with dementia. We observed one area offered a replica children’s nursery was very well used by a number of people.

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.

People and their relatives told us they felt their care was co-ordinated and staff responded quickly to any changes in their condition.

External healthcare professionals told us they were confident information given to the service was shared and utilised to ensure continuity of care. They told us information was promptly shared with people’s representatives or families. External healthcare professionals told us when they visited people at the service, staff were well informed and “staff never give up on trying to make it the best possible experience for each individual”.

It was clear from records we looked at and feedback we received systems were in place to ensure people were referred to external healthcare professionals when needed. For instance, for people who communicated distress or discomfort with agitation, advice was sought from mental health teams to ensure people were treated with dignity and staff explored possible triggers.

Systems were in place for staff to share important information to the next shift. In addition to handover meetings, the registered manager met with the heads of departments each day to cascade important information. The service checked staff’s competency to ensure they understood and applied training and best practice. Staff received support in the form of continual supervision, appraisal and recognition of good practice.

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.

People and their relatives told us people were supported to live as healthily as possible. Staff were described as identifying and responding promptly to health concerns such as infections, seizures and changes in condition, with timely involvement of GPs and other professionals.
Comments from relatives included, “They [staff] spotted when [person] had a urinary tract infection (UTI) and got the GP” and “When [person] had a seizure, they [staff] had already phoned the ambulance and were very quick.” Other comments included, “[person] had a UTI and got the GP and they needed antibiotics”, “[person] had a chest infection, and they spotted it and checked on them” and “[person] had a cough and the GP was here… he said they had a chest infection.”

People were supported with eating and drinking, with encouragement to maintain independence where possible, and adjustments made as needs changed. We observed and relatives told us staff encouraged mobility, personal care and daily activity, which helped people remain as active and independent as they were able. Comments from relatives included, “[person] has put weight on since moving in” and “They [staff] try all the time to encourage [person] to be mobile and do things for themself.

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.

Systems were in place to ensure people’s needs were monitored and reviewed. This was carried out monthly or when a change in need occurred. This was an opportunity for staff to seek feedback from people and their relatives.

We received mixed feedback from relatives about how involved they had been in reviews of care. While most of the feedback confirmed relatives were involved, “I am involved regularly and they ask me about vaccinations”, “There is a resident of the day and I get to know about [person’s] weight or other communication… they [staff] are open to having a dialogue” and “I have been involved in the care planning right at the start.” Other relatives told us, “I know [person] should be being reviewed, but I don’t always know if [person] has seen the GP” and “I am not sure how care plans are reviewed.” We have provided feedback to the registered manager to ensure communication with relatives is consistent.

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

We found mental capacity assessments were completed in line with the code of practice of the MCA. Mental capacity assessments were thoroughly completed and provided a transparent decision making process for people who lacked capacity. The views of third parties used in best interest decision were clearly documented.

Staff understood the principles of gaining valid consent and how it applied in day-to-day practice. They told us gaining consent from people before providing care and support was embedded within their working practices.

Where an MCA concluded a person was unable to consent to a decision, the service checked if a third party had legal authority to support decision making.