The Swallows

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.

The provider was previously in breach of Regulation 11 (need for consent) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and we rated this key question requires improvement.

At the last inspection people's diverse needs and wishes were not always assessed and documented. Assessments were not always completed and did not always include, people's needs relating to any protected characteristics in line with the Equality Act. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Improvements in all the areas detailed above were found at this assessment and the provider was no longer in breach of these regulations.
 

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.

At the last inspection we found that people's diverse needs and wishes were not always assessed and documented. Assessments were not always completed and did not always include, people's needs relating to any protected characteristics in line with the Equality Act. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection, people’s care plans evidenced the provider had made significant progress. Assessments had been reviewed and were completed to include people's needs relating to any protected characteristics in line with the Equality Act. These improvements meant the provider was no longer in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection the provider had reviewed and comprehensively improved their processes for assessing risks to people in their care and in developing people’s care plans to meet their needs. We reviewed 5 people’s needs and risk assessments together with their care plans and found effective measures in place both to meet people’s needs and to minimise the harm that might come to them in terms of risks. Relatives told us they felt their family members were safe and previously identified risks were monitored and managed safely and appropriately.

The manager told us they ensured pre-admission assessments were completed with people before they moved into the home so that the staff team had information and guidance on the person and how they liked and needed to be supported. A more detailed assessment and care plan was completed once they have got to know the person. This meant people were treated as individuals and had personalised care plans.
 

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.

Systems were in place to ensure information about people was shared appropriately with other services when needed. Staff worked well together and completed handovers to ensure all staff were updated on people’s care and health. Relatives told us they felt the service was safe and responsive to people’s changing needs.
 

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 and relatives spoke positively about staff. Comments included, “Staff here work together well and this means we get better care all round,” “Staff work as a team together and we see this when we visit. They [staff] are all on the same page.” People told us their experienced good quality care from the staff team.

We saw staff communicated effectively with other professionals. A staff member told us they worked closely with the GP, district nurses, the local authority falls team, podiatrist, diabetic nurses, speech and language and physio therapist, social workers and the DoLS team. They also worked with a tissue viability nurse when required however no one living at the service currently had any pressure sores.

Healthcare professionals told us they worked well together with staff in the home. They reported staff had a good collaborative approach with them and together they were able to ensure people had the care they needed.
 

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 relatives were positive about their family member’s wellbeing. Comments included, “My [family member] is encouraged to engage in the activities which include physical exercises. They seem to enjoy it and I hope it’s helping them to be healthier”, “The food is good, they enjoy it and it looks healthy enough to me.”

People were supported to access a range of health care professionals and staff monitored people’s health and well-being daily. There were regular visits from health care professionals including GPs, district nurses and dentists. A relative told us, “The staff have sorted out follow up appointments with GPs, etc and it's all been effectively managed and well documented.”
 

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 care plans were regularly reviewed, up to date, and included details of how individuals wished to be supported. Staff had access to information about planned appointments, such as medicines reviews with healthcare professionals. Hospital Passports were in place and included all relevant details about the support people required during their medical appointments.
 

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

At the last inspection we found that people's mental capacity assessments were not always completed in line with the codes of practice or had not been completed or reviewed where required. Appropriate improvements were found at this assessment and the provider was no longer in breach of this regulation. This meant that when people lacked the mental capacity to make some decisions about their care, staff consulted with their representatives and those who were important to them to make sure decisions were made in their best interests. The provider was no longer in breach of this regulation.

People were supported to understand their rights. People were provided with opportunities to discuss their views and wishes. People told us they were included with decision making regarding their care and support. We saw relevant and appropriate consent forms on people’s files that had been agreed by them and were signed and dated.

Staff told us where people had the capacity to do so they were encouraged to make their own decisions and wherever possible this was done together with their relatives. Where people did not have capacity, they supported people in their best interests. Care plans demonstrated that the Mental Capacity Act had been followed, and where necessary, a mental capacity assessment had been completed. Staff had received training around the Mental Capacity Act 2005.