Heanton Nursing 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

At our last inspection we rated this key question good. At this inspection 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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care and wellbeing and communication needs with them. Assessments were carried out using evidence-based tools to provide people with effective care and support. People’s protected characteristics were considered when planning and delivering care.Records reflected what was important to people and included information about their care preferences.

People’s communication methods were outlined within their care plans. Relatives told us they felt care and support was appropriate for their family member. Comments included, “In terms of the staff… I feel that they manage very difficult situations as far as we see with real dedication, black humour, and a terrific lot of care and time”. Another relative told us, “We are very happy with the care and feel that (relative) is safe there. The carers and the supervisors know her well and she smiles when she sees them.”

Staff knew people well and were able to describe people’s likes and dislikes. Staff had regular handover meetings to discuss any changes in people’s needs. When a new person was admitted, Staff were given time to read their care plans to enable them to support the person effectively.

Assessments were carried out using evidence-based tools to provide people with effective care and support. People’s protected characteristics were considered when planning and delivering care.Records reflected what was important to people and included information about their care preferences.

The service 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.

The provider established best practice to demonstrate individual health conditions were managed effectively. There was effective monitoring and recording of people’s needs, including nutritional and fluid intake. Recognised tools such as the Waterlow score had been used to assess whether people were at risk of skin breakdown, and the results were used to develop care and treatment to ensure good outcomes for people.

Where a person had a specific health diagnosis, for example diabetes, there were plans of care and details on how to reduce risk of harm to the person. Staff told us about people with a modified diet and the guidance they would follow to ensure their safety. We observed people were provided with the appropriate diets.

Catering staff were aware of people’s nutritional needs and when people required a modified diet. Information about modified diets was available for catering staff to refer to. Most people were positive about the food options available to them. Comments included, “The food was very good”, and “I like it. No complaints. We get a choice every day.”

The service 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’s records held details of important information for health and social care professionals, with contact details of who would be involved in people's care. People told us they had support from staff to access external healthcare services, and had access to services such as dental services, opticians and hospital appointments. Systems were in place to ensure details and correspondence from health and social care professionals who were involved in people's care remained up to date and relevant.

Staff ensured timely referrals to health care professional were made when they identified people had a specific need. Relatives confirmed their family member’s health needs were met. Comments included, “They really are on the ball and notice any changes in (family member)” and, “They (staff) are caring, the slightest thing and they are there to assist.”

Staff were positive about their teamwork. Staff worked well together and said communication between them was good. This helped to ensure people received effective and joined up care.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Care plans were comprehensive and personalised. There was information for staff on how to monitor and care for people to keep them safe and well. People and their relatives confirmed they had regular appointments with their GP and other healthcare professionals.

Staff monitored people’s weight, skin integrity and other clinical areas, using recognised tools such as the Malnutrition Universal Screening Tool and Waterlow pressure area risk assessment. The provider used additional monitoring, and oversight tools and audits to identify any clinical issues or trends and recorded actions.

Staff shared examples of how they supported people to live healthier lives. For example, putting prompt measures in place for a person who was found to be losing weight. The provider had systems in place to ensure people had access to health and social care services as and when they needed them. One relative told us, “I know if my relative had not been in Heanton care home I would have lost them a long time ago. (Person) has other health conditions, and they (staff) are on it and act very quickly with the medical conditions. I feel that is why they are still here.”

The service 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.

Appropriate referrals had been made for people who required additional clinical support, such as the tissue viability nurse, the older people’s mental health team and speech and language therapy (SALT). The GP carried out weekly reviews. This helped to ensure people’s health and treatment were routinely monitored.

People's care records had been regularly reviewed and amended according to their needs or health professional’s recommendations. Comments from professionals included, “The service maintains regular communication with us and makes strenuous efforts to ensure that they have sufficient information to support people safely” and “I have not had any specific concerns across my limited contact with the home so far”. Where external professionals reported difficulties accessing the service, the provider was working with them to improve communication and working partnerships.

Relatives said their family members’ health was monitored effectively by staff and visiting professionals. Some described the improvements in their relative’s health and wellbeing, comments included, “(Person) was very paranoid but as time's gone on and they’ve had more medical treatment, I think it's improved a little” and, “I have been so impressed with the care and understanding (person) receives, especially as their dementia is so unpredictable. (Person) is now much happier thanks to the team’s management of their needs”.

Staff said they thought standards of care were good, which led to positive outcomes for people. They demonstrated a good understanding of individual needs and responded to people’s needs and requests appropriately. The management team monitored people's care and support as well as any specific health care needs, such as diabetes or weight loss.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.Staff understood the need to seek people’s consent before providing their care and support. People who were able said staff respected their decisions and choices made on a daily basis.

The service had systems and processes to complete mental capacity assessments and work in line with the principles of the Mental Capacity Act 2005 (MCA). Where people were unable to make decisions about their care, staff generally followed the correct procedures to ensure safeguards were in place. People were supported to make decisions in their best interest by relatives and other advocates. However, we identified 1 person was missing specific records around the decision to move their bedroom. Two relatives also told us their family member had moved rooms prior to consultation with them. The management team took steps to ensure the best interest decision process was improved.

Staff understood their role in ensuring people provided their consent to the care and support offered. Staff had attended training sessions relating to the MCA and Deprivation of Liberty Safeguards (DoLS). One member of staff said, “You should always assume that people have capacity.”

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.DoLS applications had been made appropriately.We did not identify anyone who had been restricted unlawfully.