Estherene 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.

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.

Needs assessments were undertaken before people moved into the service, this included the input from the person and their representatives, where appropriate. A person’s relative told us about the assessment process, “They are absolutely wonderful… nothing more they could have done they were wonderful; they wanted to know all about my [family member].”

Needs assessments were used to inform people’s care plans and risk assessments, which were kept under review and updated when any changes to people’s needs and preferences were identified. A person’s relative told us, “Following [family member] moving into the home when care needs were fully set the team continued to support [family member] in settling in… several different carers have asked if there is anything that needs to be adapted or adjusted that we can let them know.”

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 care records included assessments which were industry recognised, such as the malnutrition universal screening tool (MUST).

People’s dietary and hydration needs were assessed and actions taken to ensure they were met. The catering staff understood people’s specific dietary needs and how they were met. This included specific textures of food and drink, as directed by the speech and language therapy team (SALT). Information about textures and the types of food suitable for example a softer diet, were posted in the kitchen area. People told us they felt the quality of the food was good. A person said, “The food is very good and healthy.”

There were hydration points throughout the service, where people could help themselves to drink, or where they were not able, ask staff for drinks. We observed staff ensured people had access to drinks and were encouraged to drink. A staff member told us as well as drinks, people could have ice lollies to increase their intake.

People told us they got enough to eat and drink. People had access to snacks as well as their regular meals. During lunch, we saw people were offered second helpings, if they wanted them.

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 registered manager told us how they worked well with other professionals involved in people’s care. Referrals were made, as required, when there were concerns about people’s wellbeing. This included to professionals such as the GP and falls team.

The registered manager told us how the local GP surgery held meetings, where various subjects were discussed which provided guidance and information how to, for example, recognise infections. In addition, mental health teams had provided advice and guidance on how to support people with their distress and anxiety.

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 told us they had access to health professionals when needed, such as the GP. Where people had received treatment, or guidance was received from health professionals, this was documented in their care records. A person’s relative told us, “The staff always keep us informed of any concerns for [family member’s] wellbeing. I will get a call from the office anytime any medical assessments need to take place and with regards to major appointments they will support with liaising with hospital and arranging transport for me to go alongside [family member], or a staff member will be available to attend along with me or in my place if needed.”

A person told us how they liked to walk to stay healthy and told us how many laps of the service they tried to do each day, “I can do what I want.”

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.

The management team monitored people’s food and fluid intake and advised staff when additional action was needed, for example if a person had not met their daily fluid targets. People’s weights were kept under review and referrals made to professionals, such as a dietician, if a person was losing weight, for example. Where required, people were provided with high calorie foods and snacks to increase their intake.

Systems were in place to ensure people’s personal care needs were met. This included monitoring showers/baths and oral care. Staff were advised when it had been noted people’s daily records did not show people were offered and received support. Not all of the care plans reviewed detailed the care and support people required with their oral health needs, the registered manager told us this would be addressed. A person’s relative told us they felt their family member’s personal care needs were being met, “[Family member] is always smart and clean.”

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

People’s capacity to make their decisions about the care they received was assessed. Where people lacked capacity, the arrangements were documented in how best interest decisions were being made. People’s records guided staff to ensure people’s choices were respected and acted on. The management team told us they were strengthening the ways people’s consent and decisions were documents when they shared rooms.

We saw staff asked for people’s consent before providing any care or support.