Dorset 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.

People’s needs were assessed before they moved into the service. A relative said, “They (staff) came to the house and did an assessment.” Pre-admission assessments ensured people’s needs could be met. Assessments consisted of gathering information from the person and those important to them. This included contact details for health and social care professionals involved, medical and clinical profiles, cognition and capacity, family involvement, and life stories. This information was then used to develop personalised, person-centred care plans which guided the delivery of care and support. For new admissions into the home, a ‘New Admission 'Settling in' Checklist and Day 8 Audit’ was completed. This covered pre-admission preparation and readiness, actions required within 24 hours of arrival, and actions required within 7 days. The clinical lead member of staff was responsible for completing the Day 8 audit and a clear process for reviewing people’s needs was in place.

Staff demonstrated a good knowledge of individuals and their support needs. Systems were in place to ensure care plans and associated records were regularly reviewed and updated to reflect current needs. Records were updated sooner if a person's needs were to change.

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.

We saw evidence people were involved, where possible, in their care planning. Care plans clearly outlined the support people required to maintain good health and wellbeing. Staff actively monitored nutritional intake, and where concerns were identified, timely referrals to relevant health professionals such as the Speech and Language Therapy (SALT) team were made. This proactive approach helped prevent any deterioration in people's health. Kitchen staff were kept fully updated on individual dietary requirements to ensure meals were in line with people’s assessed needs. People were able to choose what they wanted to eat from the menu. One person said, “The food is very good. I’m not fussy, I enjoy most things.” Another person told us, “Adequate for food and drink. All my food has to be mashed up. I do like a variety. I can’t say I ever feel hungry.” A relative said, “At home, [person’s name] was staying in bed most of the day. Now there is a clear routine for getting up, for food and drink. [Person] is eating stuff they would never eat at home with no bother at all.” Another relative shared, “There is so much choice for snacks and drinks.”

We observed a positive, person-centred mealtime experience. Dining tables were well-presented with tablecloths and fabric napkins. Printed, laminated A4 menus featuring food photographs on the reverse were available on each table to support visual choice. Staff engaged meaningfully with people when serving meals. For individuals requiring assistance with eating, staff provided support in a dignified, unhurried, and respectful manner.

The service used recognised assessment tools to monitor areas including nutrition, falls, choking risks, skin integrity and frailty. Electronic systems also prompted staff to complete key interventions, such as repositioning and hydration, helping to identify concerns early and reduce the risk of deterioration.

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 accessed external healthcare professionals, and care plans evidenced the relevant referrals to external professionals had been made when required. Staff worked well together and communicated well with each other whilst supporting people. They told us they had regular handovers to share information. For example, one staff member told us during daily 10@10 meetings the registered manager discusses service user updates and concerns. These include weight monitoring, tracking bowel movements, reviewing general well-being and managing upcoming appointments.

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 were supported to maintain and improve their health through regular monitoring, timely access to healthcare professionals and personalised care planning. Care plans contained information about people’s health conditions so staff could recognise any signs or symptoms which may indicate a deterioration in their condition.

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.

There were monitoring systems in place to monitor people’s health, such as pressure ulcers, fluid watch and weight monitoring. Tools in place gave feedback on people’s health and provided a system to flag issues early. Care plans were audited and reviewed to ensure information was accurate.

Through a long-term partnership with a Wellness Coach, wellbeing was embedded as a core element of everyday care. People were assessed using functional measures such as sitting, standing, walking, balance and upper body movement, enabling progress to be monitored and care adapted according to individual outcomes. One person said, “I get enough exercise, you need to use it.” A relative said, “I came in the other day, and [person’s name] was doing exercises and they were joining in. I did too.” The wellness coach role extended far beyond delivering exercise sessions they also provided ongoing coaching, mentoring and practical support to Lifestyle Teams, Clinical Leads and Managers, building the confidence and competence of the staff team to independently deliver the Rotherwood Wellness Programme. In addition, bi-monthly Wellness Live events were held. These events brought people and teams together from all the provider’s home for an interactive shared experience. The live sessions combined exercise, music, quizzes, themed celebrations and specially prepared food, creating opportunities for people to exercise together, celebrate achievements and build relationships across the wider Rotherwood community. These events promoted physical health, reduced social isolation, encouraged laughter, stimulated cognitive engagement and created a genuine sense of belonging.

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

People were supported to make choices and decisions about their care wherever possible. For example, staff encouraged people to remain involved in day-to-day decisions such as meals, activities, personal care, and daily routines.

Staff had undertaken relevant training on the Mental Capacity Act 2005 (MCA). There were systems in place, and the provider understood their responsibilities in relation to the MCA. Where a person may be lacking capacity, appropriate assessments had been carried out.

We observed staff knocking before entering people’s bedrooms and speaking with people before carrying out any activity or tasks.