Otto Schiff

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 completed detailed pre‑assessments before admission and used this information to develop person‑centred care plans. Care plans reflected people’s physical health, nutrition, mobility, communication, risks and cultural needs, including religious preferences, and staff reviewed these regularly.

Staff understood people’s needs well and were able to describe how care was adapted to meet changes in their condition. One staff member told us, “We get information from handover informing us what people need. Management tell us to read the care plan.” The provider worked with external professionals, including GPs and specialists, and involved people and their representatives in reviewing care and treatment.

The provider involved relatives in care planning and review processes. One relative told us, “I help write (the person’s) care plan,” demonstrating partnership in planning care.

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.

The provider used recognised assessment tools and guidance to plan care, including for nutrition, mobility, skin integrity and risk management. Care plans provided clear, detailed instructions for staff, and the provider worked with professionals to ensure care and treatment met people’s needs.

Staff demonstrated they understood how to deliver care safely and in line with best practice. One staff member told us, “I have to support [person] slowly, finish what [they] are chewing before another,” which reflected safe support for people with swallowing needs.

Staff delivered care that reflected people’s preferences, including cultural and religious needs, and involved people and their representatives in planning and reviewing care.

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 shared information and escalated concerns appropriately, working with other professionals to ensure people received timely support.

Staff communicated effectively within the service through daily handovers and electronic care records, which supported consistent care delivery and understanding of people’s needs. The provider maintained communication with families and professionals when people’s needs changed, including during hospital admissions and discharge, to ensure continuity of care.

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.

The provider monitored people’s health through regular assessments and observations, including nutrition, hydration and weight. Staff worked with professionals such as GPs, dieticians and speech and language therapists to support people’s physical health and ensure appropriate interventions.

We observed staff supporting people with eating and drinking and engaging people in activities that promoted wellbeing and interaction. Staff demonstrated an understanding of recognising changes in people’s health.

The provider helped people to access meaningful activities, which contributed to their overall wellbeing.

Relatives told us they were kept informed about people’s health needs and appointments. One relative said, “Any appointments I would be informed.”

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.

Staff recorded and monitored people’s care through daily records and regular assessments, including nutrition, hydration and health observations. The provider reviewed care plans regularly and maintained oversight of care through audits and checks to ensure care remained appropriate and effective.

The provider analysed incidents and events to identify trends and improve outcomes, with information reviewed daily, monthly and quarterly and shared with staff to support improvements in practice. The provider used learning from incidents and feedback, including reflections following people’s deaths, to drive improvements across the service.

People and their relatives gave consistently positive feedback, indicating that care met people’s needs and expectations.

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

Staff understood the principles of consent and the Mental Capacity Act (MCA) and described how they adapted care based on people’s capacity. One staff member told us, “I would treat people different around their capacity, person centred care.” Care plans included information about people’s capacity and recorded decisions relating to care and treatment, including where consent had been obtained.

The provider involved people and their representatives, including those with power of attorney, in decisions about care and treatment. Staff encouraged people to make choices wherever possible and respected their preferences and routines when delivering care.

We identified a minor area for improvement in relation to the documentation of capacity assessments and best interest decision-making for 1 person, which the provider acknowledged. This was not identified as a wider theme.