Stone Barton Short Break

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.

This is the first assessment for this newly registered service. This key question has been rated 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’s needs were assessed through a structured pre-admission process where individuals visited the service to determine suitability. Care plans were detailed, included communication needs, risks such as dysphagia and PEG feeding, and were regularly reviewed with involvement from relatives. We were provided a care plan which we identified had some inconsistencies and contradictory information within support plans, including guidance relating to health care needs. However, the registered manager informed us, this was an old copy and a newer copy was accessible to staff and was updated as they had already identified inconsistencies.

Staff told us care plans were “Easy to understand” and updated promptly when needs changed.

Relatives informed us they were involved with care planning. Comments included, “I am involved in the care plan”, and “They are very proactive. We have just reviewed the care plan.”

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.

Staff followed professional guidance such as SALT (Speech and Language therapy) recommendations which included International Dysphagia Diet Standardisation Initiative (IDDSI) framework and PEG feeding regimens. Observations showed people receiving food and fluid in line with professional guidance. Staff we spoke to told us about people's individual needs which were in line with peoples assessed needs.

We received mixed feedback from relatives, comments included, “They (Staff) have had meetings with speech and language. There are guidelines about what (Person’s name) is allowed. The dietitian decides how much and when”, another said, “Once I arrived (Person’s name) should have been having their feed, but they had done it too early or too fast.” The management team informed us that several concerns had been raised by the same relative. These concerns were reviewed and investigated, with some not being upheld. However, where investigations identified learning opportunities or areas where the service could have acted differently, they had acknowledged these with the family and shared the actions taken in response.

We observed dietitian feeding regimes being followed and allowing time to meet people’s needs.

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.

Staff worked closely with families, who were involved in care planning and reviews, and communication tools such as communication books and handovers ensured continuity of care.

Staff described good teamwork and regular meetings to share information and improve practice.

The service worked with health professionals, including nursing support for delegated tasks, although there were some challenges accessing consistent community nurse involvement.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

Staff supported complex health needs including PEG feeding, medication regimes and specialist diets in line with professional advice. People were supported to access activities, maintain routines and develop skills.

Relatives described how staff adapted care to meet individual needs and promote engagement. One relative told us, “They offer (Person’s name) tasters. (Person’s name) is still involved in cooking.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. However, they ensured outcomes were positive and consistent.

We saw records of routine monitoring overnight. However, we identified more detail was needed to evidence people’s assessed needs were being met. We discussed this with the registered manager, who told us they would speak to staff to ensure more detail was included.

We also identified a person’s feeding regime was due for a review. We discussed this with a staff member and registered manager who told us they would ensure this was followed up.

Care records demonstrated outcomes such as people’s personal goals and daily experiences were monitored. We saw evidence of people achieving meaningful outcomes, including participating in activities and developing skills.

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 saw records of mental capacity assessments in line with legal frameworks.

Staff told us they sought consent before care and supported people to make choices using visual aids, communication tools and observation of non-verbal communication.

Relatives confirmed people were involved where possible and staff respected privacy and dignity, with one stating staff “Always ask their permission to enter.”