Clifton View Care 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.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

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 and their relatives told us they were involved with planning their or their family members’ care. People and their relatives we spoke with felt they could talk about their or their family members’ care needs and had the support of staff. One relative told us, “The staff know my family member well and all of their ‘quirks’. The staff change their incontinence pad regularly.”
People and their relatives were confident that their or their family members’ needs were understood by the staff team. One person told us how caring the staff were and how well they were looking after them in relation to their skin. This followed a recent poor experience during a hospital admission. They said, “I’ve decided to stay in my room at the moment as I’ve got sore legs from hospital, where I was often left wet for ages. It was very poor care. I’m so glad to be back home and kept clean again.” Relatives who also cared for people, told us that staff also understood their needs and how best to support them. One relative told us, “My family member is prone to urine infections, so they keep us updated and regularly check on this. They will update us when needed. The office team are very approachable.”

Staff told us they had time to review care planning documents, so they could keep up to date with people’s changing needs. Staff we spoke with showed a good knowledge and understanding of how to support people’s needs, and what action to take if the person’s needs appeared to have changed.Staff had access to documents on how to support people. Where people’s needs changed, these care planning documents were updated so staff understood people’s changes in needs. For example, where a person’s mobility had reduced, staff had made a referral to an external health team for occupational therapy input for equipment to support their needs. People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people, to have a clear understanding of the person’s needs.

A range of national assessment tools were used, to understand people’s needs and how best to support them. For example, the malnutrition universal screening tool (MUST) was used for the management of weight loss and nutritional intake.
 

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 and relatives felt engaged in planning their or their family members’ care. We saw care plan reviews had involved the person and their relatives, if appropriate. Relatives we spoke with told us they had involvement with care planning and were kept updated on any issues arising. One person said, “Luckily, I can manage most things by myself and have a shower when I want. I appreciate the freedom.”

Staff kept records on how they had supported people and at what time. There was consistency in these daily records for food and nutrition, oral care and personal care. The Registered Manager regularly audited planned care records, to identify and address any concerns or shortfalls. For example, where a persons’ diabetes management needs may require review by an external health care team.However, we found a lack of consistency in these daily records for the repositioning of some people. This meant people were at potential risk of their skin management needs being met. The Registered Manager reviewed these promptly during our assessment and submitted an updated process to ensure this action was completed. We will review the implementation of this at our next assessment.

Staff worked in accordance with best practice principles in dementia care. Display boards across the service included, ‘understanding dementia’ and ‘back in the day’. The service had a range of visual displays, with pictures and photographs of the local area and the city of Nottingham. These enabled staff and people to have meaningful conversations and reminisce about their life histories.

People’s communication needs were clearly recorded, to enable staff to effectively communicate with people. For example, care plans for people who had specific communication requirements were detailed and personalised. Information for staff to support a person’s spiritual beliefs was included within care plans. Where people may speak in other languages or require the use of accessible information in an alternative language this had been fully considered.

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 had clear pre-admission documents in place, detailing their individual needs. The management team assessed their capacity to support people based on the overall dependency needs of the service.

The service worked well with external health and social care partners and implemented guidance from these teams to support people effectively. The Registered Manager explained the measures they had put in place, to improve the working relationship with the staff from the external health provider, based at the service. In order to reduce any issues with communication, everything was now being documented during daily handover meetings between the 2 teams. The understanding for people using the rehabilitation beds from people and their relatives remained an issue and both teams were still working on this. People using the rehabilitation beds sometimes struggled to differentiate between what was offered from the external health provider, and what the service were responsible for. It was hoped the improved communication would support people and their relatives in understanding and expectations.

The service had a positive relationship with their covering GP practice, who visited regularly to carry out review of medicines or any changes in clinical conditions.

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 and their relatives gave positive feedback about the support provided by the staff team. One person said, “The district nurse visits twice a day for my insulin and the staff recognise my ‘hypers’, as I just drop. My family take me out to my dentist and optician, but I have the chiropodist here. Our hairdresser here is very good.”

Staff members we spoke with told us about the positive relationships they had with external health and social care teams. The senior team showed professionalism and confidence in raising concerns with the covering GP practice, pharmacy and external health teams.

Staff were competent with responding to falls experienced by people. Records showed staff members had acted appropriately following falls incidents at the service. Referrals were made to external teams to help mitigate risks effectively. For example, people who had experienced falls and injuries had been referred to professionals for specialist input to help mitigate this risk. Where referrals had been made, these had been followed up in a timely manner by the service. This ensured people safe and effective support.

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.

People's needs were robustly assessed, so their care and support could be delivered in line with current standards. This supported people to achieve effective outcomes. Care plans had clear guidance for staff to follow, to ensure people received their planned care and support during the day and at night.

People were supported to maintain good nutritional intake and hydration levels. The service had an experienced kitchen team, who understood where people had been prescribed a specific diet to support with a clinical condition.

The Registered Manager explained how they had improved their auditing and oversight of care plans. The Registered Manager was supported in this, by an experienced senior team. During our discussions with the team, it was clear they knew people well and ensured any concerns related to people were promptly raised.

Care plans were person-centred, and detailed people’s skills, life experience and strengths. People and relatives, we spoke with had been involved in regular reviews of their plans of care. People and their relatives were positive regarding staff being hardworking and understanding of their needs. A relative told us, “We’re all on first name terms and they’re so friendly. My family member is treated kindly by the staff.” Another relative said, “The staff understand my family member so well, they are very patient with them.”

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment.

People we spoke with all told us staff asked for their consent before delivering personal care. Nobody raised concerns around feeling unnecessarily restricted and they explained how their preferences were respected. One person said, “Staff will always ask me first, then close my door for care, but I like it open the rest of the time as I don’t like feeling shut in.” A relative told us, “They made a point of asking us and we know my family member prefers female carers, so that’s respected.”

We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.