Averley Home

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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.

This is the first assessment for this service under the new provider. 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 thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s health, social and emotional needs were assessed before they moved to the service. These assessments were used to develop each person’s care plan. Care plans contained detailed information about their daily lives and support needs. This included supported people needed with their personal care and how many staff and what equipment people needed to be able to move around their home.

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 needs around their eating and drinking had been assessed and guidance sought from health care professionals where people were at risk of choking. Where people were prescribed a modified diet this information was recorded using the International Dysphagia Diet Standardisation Initiative (IDDSI). This guidance was located in the kitchen so it was available for staff supporting people to prepare their meals. IDDSI isa global framework providing a common language for texture-modified foods and thickened liquids for people with swallowing difficulties.

One person told us they knew what was for dinner each day by looking at the menu, which was on display. People had access to the kitchen and those who were able could make themselves a drink. We observed people being offered drinks and people’s fluid levels were reviewed to ensure they had drunk sufficiently to remain hydrated. Staff sat with a person whilst they were eating their lunch. The person hummed whilst eating which indicated they enjoyed their meal.

The provider worked well across teams and services to support people.

The service worked with a wide range of health and care professionals including community nurses, physiotherapists and speech and language therapists.

During the assessment visit, staff were concerned about the high oxygen levels of one person and a district nurse visited to carry out a health check. Staff gave positive feedback about a recent visit from a physiotherapist which involved people trying out a piece of equipment. This equipment encourages people to pull themselves up when rising from a chair and therefore helps promotes people’s independence.

The provider did not always support people to manage their health and wellbeing so people could live healthier lives, or where possible, reduce their future needs for care and support.

Some people had been recommended physical exercises such as hydrotherapy and cycling to help maintain their mobility. However, these people had not been attending these sessions regularly. Staff told us this had resulted in a deterioration in their mobility. The registered manager explained that people had not attended some sessions due to a lack of staff funding to support them. A relative also told us, “They have a car but I don’t think they always have drivers, so I’m not sure how frequently they go out.” A health professional commented that one person living at the service spent a lot of time in bed. One person told us they went swimming last week and although they had not been cycling recently, they were now able to cycle by themselves around the whole track.

Relatives told us they were confident that staff supported people with their health and to live healthier lives. They told us that they were kept informed of any medical appointments and their outcomes. People had yearly health checks, and regular appointments such as with the dentist and chiropodist. One relative said, “Staff seem to top of it all.” Staff monitored people’s health by keeping people’s weights under review to assess if there were any significant changes.

The provider monitored people’s care and treatment to continuously improve it.

The service used a keyworker system. A keyworker is a named member of staff who has responsibility for working with certain people, taking responsibility for planning that person’s care and liaising with family members. Staff described the importance of maintaining contact with people’s families in order to ensure good outcomes for people.

The registered manager told us they were reviewing people’s goals to ensure they were meaningful for people. This was in line with the principles of ‘Right support, right care, right culture’. Goals were written in a way to help people understand using pictures. We observed staff supporting a person with one of their goals during our assessment visit.

Staff understood the importance of gaining people’s consent and respected this when delivering person-centred care and treatment.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) to respect people’s choice to make decisions whilst giving them relevant information and encouragement so they could make a fully informed decision. We observed staff gaining people’s consent before offering any support or assistance.

MCA assessments had been carried out with regards to aspects of people’s daily living. This included being supported with personal care and medicines. Assessments followed MCA principles by helping people to understand the information, by giving it to them in different ways and formats. Checks had been carried out if people could retain and weigh up the information to communicate their decision. Where people had been assessed as not having the capacity to make a specific decision, discussions had taken place to ensure the decision had been made in the person’s best interests.