Adam 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 good, and people’s feedback generally 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 service did not always make sure people’s care and treatment records were effective because they did not always check, discuss and update information relating to people’s health, care, wellbeing and communication needs with them/their loved ones.

People did not always have appropriate assessments in place in their care plans. For example, one person did not have an oral care plan in place despite being classed as high risk in their oral risk assessment. People did not always have positive behavioural support plans in place when this was needed. Care records were not always detailed, and whilst some people’s needs were appropriately assessed this was not always reviewed regularly in care plan reviews.

Staff told us the management team and senior care assistants were involved in creating peoples care plans.

The service 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 had appropriate nutritional care plans and risk assessments in place where needed. People and their relatives said they received enough to eat and enjoyed the food. One person said, “(the food was) Alright, I had Alpen for breakfast." We found some examples of necessary referrals should anyone need clinical support. The registered manager told us how they supported people to retain relationships with family especially for those who lived out of the direct area. They told us, "(People keep in touch with loved ones) However they want, (by) telephone calls, visits, overnight stays (at home)."

The service generally 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, but some records could be improved.

People and their relatives felt services worked together. Relatives said people got to see the doctor when they needed to. One person said, "I go for checkups, they (staff) support me yes." Staff spoke about how they are told when people’s needs change. One staff member said, “We’d have it (any changes) handed over verbally, and it’d be on logs. We read their (people’s) notes and care plans. We’re advised when to re-read care plans.”

Emergency transfer sheets were in place (hospital transfer sheets), which held relevant information for each person. These are documents that are sent with a person if they need prolonged external support, for example, if a person was sent to hospital. These documents help to ensure the hospital was aware of (and could meet) people's needs on admission.

We saw evidence of handover records, and we saw evidence of the registered manager working with other services to try and drive improvement. Health professionals told us they felt they had a good handover of information, but some feedback echoed our concerns that records were not always sufficiently up to date.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had access to healthcare support when they needed it, and staff spoke about how they monitor/record people’s health.

The service ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Work was needed to improve the consistency in which they monitored people’s care and treatment to continuously improve it.

Some relatives spoke about improvement in their loved one’s outcomes. One relative said “I would say how they manage things is amazing, you couldn’t take [person] in a shop before they lived there, but they’ve worked really hard with [person]. I went to a coffee shop with [person] recently, and I’ve not been able to do that in years.” The registered manager told us how they review and monitor people’s care. They spoke about how people’s weights are monitored, they said, "People are weighed once a month, if they agree." Appropriate tools were in place to manage people’s weights, but people’s care plans were not always being regularly reviewed in line with policy.

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

People and their relatives told us that staff asked for consent before delivering care. One relative said, “Yes (they ask for consent)…… They (staff) say to [person] “is that alright” throughout and are very kind.”

The registered manager spoke to us about the various areas where consent is needed and appropriate consent forms were in place.