Blythe House

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 assessed people's needs using information from all relevant people in their life and reviewed the support they received to help ensure care remained effective. Assessments focused on what was important to people and how they wanted to live their lives. Care records showed how staff should support people in ways which reflected the principles of CQC’s policy on Right Support, Right Care, Right Culture. This included promoting choice, supporting independence and helping people take part in their local communities.

People and, where appropriate, their relatives were involved in reviews and decisions about their care. Relatives told us they were very happy about how care needs had been assessed and care provided since their family member moved into the service. They said, "[My family member] has never looked back. The best move they ever made living at Blythe House, as far as the whole family are concerned it is brilliant."

Care records currently used both electronic and paper systems, which had resulted in some duplicated and contradictory information in places. The registered manager had recognised these issues and was taking action to improve them.

The staff team delivered care and support using information about people's needs, health conditions and experiences to help ensure support remained effective. Staff maintained detailed records about people's health and wellbeing which were used to inform reviews and decision making. For example, information about seizures, medicines, distress and dietary needs.

Appointments with healthcare professionals was recorded and monitored. This helped staff and healthcare professionals identify changes in people's needs and review support when required.

People's health conditions were supported using guidance based on current professional recommendations. Staff followed clear protocols for people with epilepsy, complex allergies and dietary needs. Staff understood the support people needed and demonstrated a good understanding of associated risks.

Staff worked with a range of professionals, including speech and language therapists, psychologists and specialist health teams, to ensure care reflected current guidance and advice. Communication support was adapted to meet individual needs and included the use of Makaton, visual information and pictorial prompts where appropriate.

Support plans were used to help staff understand the reasons behind people’s distress and how best to respond. These plans were regularly reviewed and supported staff to use the least restrictive approaches. Any restrictions were monitored to ensure they remained appropriate and were in the person's best interests.

Staff knew people well and used information gathered through reviews, keyworker meetings, observations and day to day support to adapt care when people's needs changed. This helped ensure care remained relevant to people and reflected what was important to them.

The provider worked effectively with other teams and services to help ensure people received coordinated care and support. Information was shared appropriately between staff and external professionals to help people experience consistent support.

People were supported to access a range of services and specialist professionals when needed. Advice and recommendations from professionals were incorporated into people's support plans. Staff monitored people's wellbeing and shared relevant information with professionals when concerns or changes were identified.

The provider had systems in place to support continuity of care when people attended appointments, received input from external services or experienced changes in their needs. Important information about people's health was available to help ensure other services understood how best to support them.

Relatives were involved in reviews and discussions about care where appropriate. One relative told us, "I am involved and when I go to any of the meetings, my [other family member] comes with me because if anything happened to me they would take over anything that needed doing."

The provider was exceptionally effective at supporting people to maintain and improve their health. Staff worked closely with people, relatives and healthcare professionals to achieve positive outcomes and reduce the risk of avoidable deterioration in people's health.

Several people lived with complex health conditions, including epilepsy, severe allergies and sensitivities to certain foods and medicines. These conditions could have serious consequences if not managed correctly. Staff demonstrated a detailed understanding of people's needs and followed clear guidance to keep people safe. Robust arrangements were in place to manage allergies, including separate food storage, dedicated preparation areas and measures to reduce the risk of cross contamination. Specialist equipment and environmental controls were also used where required to support people's health needs.

The impact of this support was significant. Effective management of people's health conditions had reduced hospital admissions and helped people maintain their wellbeing. Staff carefully monitored people's health and responded quickly when concerns were identified. Information about seizures, medicines and other health conditions was clearly recorded and reviewed to support decision making and identify changes in people's needs.

Staff worked proactively with a range of healthcare professionals to ensure people received the support they needed. People attended routine health appointments, annual health checks and specialist reviews. Recommendations from healthcare professionals were incorporated into care records and staff understood how to put this guidance into practice.

Relatives spoke positively about the support people received to stay healthy. One relative told us, "[My family member] is very healthy now, it is all fresh fish, fruit, meat, eggs, they avoid foods they are allergic to. They do very well there and I am very pleased." Another relative said, "During heath reviews, we go to them, they treat [my family member] great and respect their choices and involve us. They listen."

The provider had developed clear information to support healthcare access. For example, hospital information was available for people with complex health needs to help ensure important information could be shared quickly when receiving treatment from other services. Staff also used communication tools and personalised information to help people understand their care and remain involved in decisions about their lives.

The provider did not consistently monitor people's outcomes from goals and the oversight systems were not always effective in driving improvement in this area. Leaders reviewed incidents, accidents, audits and feedback to understand people's experiences and identify where changes were needed.

People had goals in place and staff reviewed people’s achievements and aspirations in monthly keyworker meetings. However, most goals were outdated and there was not always a consistent approach to recording progress and outcomes. This made it more difficult to clearly demonstrate the impact support had on helping people achieve their aspirations.

Despite these findings, people continued to receive positive outcomes, one person was able to tell me about a goal they were working towards and what they had learnt from it so far. Relatives were generally positive about the quality of support provided. The registered manager had already identified the areas requiring improvement before the inspection and had started work to strengthen goal setting.

The provider respected people's rights to make decisions about their care and support. Staff sought consent before providing support and encouraged people to make choices about their daily lives wherever possible.

People were supported to understand information and take part in decisions about their care. Mental capacity assessments contained detailed information about how staff had adapted their approach to help people understand the decision being considered and communicate their views. Decisions were considered on an individual basis and reflected the principles of the Mental Capacity Act 2005.

Where people lacked capacity to make specific decisions, appropriate assessments had been completed and best interest decision making processes had been followed. Records showed people, relatives and relevant professionals had been involved where required. Staff understood the importance of promoting choice and supporting people to have control over their lives.

People made choices about how they spent their time and whether they wanted support from staff, who respected these decisions. People were supported to express their preferences using verbal communication, Makaton, pictures and other personalised approaches.