Steep House 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

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 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.

A relative confirmed, “We are all involved in the care plan.” The provider ensured each person’s care plan was reviewed monthly and their views and those of their relatives sought, through their ‘Resident of the Day process.’

Staff understood people's care needs. A staff member said, “If we need any further support the nurses are happy to give us further instruction and support. There is good communication between the staff.”

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 used nationally recognised clinical tools to assess and monitor people's needs and risks. Staff then reviewed these tools monthly to ensure they reflected people’s current needs and risks. Where people had specific clinical needs or risks for example, in relation to falls, pressure care, catheter care or wound care their records reflected and referenced good practice guidance.

People's nutrition and hydration needs were documented and any associated risks such as from weight loss and choking had been identified and addressed. There was guidance in place which was shared across the staff team to ensure people who required a modified diet were given meals of the correct consistency. People at risk of weight loss received fortified meals to boost their calorie intake. Overall feedback about the meals provided was positive. People said, “The food is really good, and there's plenty of it” and “The food is good and [person] always has a choice.”

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's electronic care plans were clear, accessible to staff and updated following any guidance received from external professionals. A health care professional confirmed, staff knew people well and provided them with useful information, to enable them to review people.

People and relatives felt staff worked well together both as a team and with them. A relative commented, “The communications are very good.” Whilst a staff member confirmed staff worked well together, with handovers of relevant information about people between each staff shift. There was also a daily staff allocation and head of department meeting. This ensured staff were allocated to support people across the home and any emerging issues were identified and addressed.

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’s care plans enabled staff to understand their healthcare needs, including their preferences about their healthcare. The care plans also promoted healthier options for people, for example, in relation to their dietary choices.

Staff arranged for people to see a range of health care professionals and there was a weekly GP clinic. We saw an optician visiting a person and a relative told us how staff supported their loved one with their oral healthcare and told us a dentist visited the home.

Staff used nationally recognised tools, in order to establish people’s baseline observations and to monitor and identify if they were deteriorating and to then escalate and act upon any concerns. Staff had also completed training in sepsis awareness, to ensure they were aware of the signs and symptoms and the actions to take.

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.

A member of staff told us they identified what people’s care needs and risks were at the initial assessment, they then identified the interventions required to meet the person’s needs and to manage risks to them. They told us the effectiveness of the interventions was then reviewed, which enabled them to make any required changes to people’s care.

Relatives provided positive feedback regarding the outcomes from people’s care. A relative said, “I think she’s improved a lot since she’s been here.” People’s care plans detailed their needs and the expected outcomes from their care.

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

The provider sought people’s written consent for their care. People’s care plans noted their capacity to make decisions and where they had variable capacity the types of decisions they could make for themselves and any support, they required from staff in order to make decisions.

Staff had completed MCA training and understood the principles of the MCA and its application in their work. People’s MCA assessments were person-centred and decision specific. People’s MCA assessments noted the measures staff had taken, to try and enable them to make decisions. Where people lacked the capacity to make decisions about their care, any decisions were made in their best interests and involved both their legal representatives and any relevant parties.