The Cumberland

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 the same 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.

People’s needs were assessed with them and their loved one before they moved into the service to ensure staff had the appropriate skills, training and knowledge to meet their needs. Relatives confirmed they had been involved in the development and review of their loved one’s care records. Comments included, “My [loved one] came in for 2 weeks respite and we then discussed [them] coming here full time as I felt I was unable to manage [them] at home any longer,“ and “I attended a meeting with the manager to discuss the care needs.”

Staff understood people’s health, care and communication needs. A member of staff spoke about how they communicated with an individual who did not use verbal communication. They said, they would read the person’s notes to check on their mood, observe their body language and check their records such as, food and fluid intake. People’s personal preferences had been transferred into their care plan and changes were made to breakfast times as a result.

Clinical assessment tools had been used where appropriate for example, ‘MUST’ a malnutrition screening tool and a ‘Waterlow Score’ which is a tool used for pressure ulcer prevention. Measures were put into place to manage potential identified risks. Staff told us People’s assessments were continuous to understand people and their care needs which were reviewed on a monthly basis.

Relatives felt the staff looked after their loved one’s health needs and worked alongside external health care professionals to ensure they remained as healthy as possible. Comments included, “The staff have a good relationship with [person] especially [staff name] who is very good with him always chatting to him and making sure he is ok” and “They look after all of [Loved ones] health needs and are very kind.”

Staff followed guidance from health care professionals in relation to people’s nutrition and hydration. For example, following the International Dysphagia Diet Standardisation Initiative (IDDSI) Framework, which is an international set of descriptors describing texture modified foods and thickened liquids for people with eating, drinking and swallowing problems (dysphagia). People’s nutritional needs had been assessed and if required people received a fortified diet which involved deliberately increasing the nutrient content of foods.

Cooks and kitchen assistants prepared hot nutritious food, drinks and snacks throughout the day. There were menu options in place and people were able to choose their meals or request an alternative if they wanted something different. The kitchen team kept a list of people’s dietary requirements and any specific food consistency. Referrals had been made to the dietician when concerns had been raised about the person’s nutritional intake.

Staff worked alongside external health care professionals to ensure people remained as healthy as possible. Relatives told us staff supported their loved one at any follow up appointments with external health professionals. A relative said, “[Staff] keep us updated if there has been a change to [name] health needs and if they have had to involve any other health professionals.”

Staff worked alongside multidisciplinary teams involved in the person’s life such as, the mental health team, district nursing team and the dietician. Records of visits, guidance and information from other professionals was detailed and easily accessible to all staff.

Staff told us they discussed people during daily handover meetings and if any concerns were identified, referrals would be sent immediately to the relevant health professionals. A member of staff gave an example of a referral made to the dietician due to concerns about a person’s weight loss. This person was supported by the dietician to change their diet which was shared with the staff team and to the catering staff. The registered manager told us they made referrals to external health professionals if there were any concerns, and any instructions would be followed by the staff team.

People were supported to remain as healthy as possible. Relatives told us staff encouraged people to do as much for themselves as possible. Some people had been prescribed specialist equipment to increase their health and well-being. For example, pressure relieving cushions and pressure relieving mattresses to reduce the risk of skin breakdown and damage.

People’s weight was closely monitored and if required people received a fortified diet, this was catered for. We observed people chatting amongst themselves, making choices over their meals and condiments and a relaxing atmosphere during lunch.

Staff supported people to maintain positive outcomes whilst maintaining and improving their quality of life. Relatives told us staff supported their loved one to engage in activities and tasks that were important to them. A relative when speaking about the staff said, “They interact with him all the time [staff name] is excellent with him, will come to his room to try some activities with him. He loves to punch a balloon although can’t really take part in a lot anymore.”

People’s care records were monitored on a regular basis and changes were made when required. Clinical monitoring tools were used by staff with the support of relevant health professionals. A person’s well-being and confidence had increased following a referral to the speech and language therapist and with their support the person was verbally more confident and joining in activities on a more frequent basis.

The registered manager gave examples of how people’s outcomes had improved with the support of health care professionals and staff following consistent guidance. For example, 1 person had daily high anxiety and was agitated, staff worked alongside the mental health team and listened to what the person wanted to achieve. As a result, the person was now calmer and no longer had periods of high anxiety.

We observed people’s consent being sought from staff prior to any care or support being given. Relatives confirmed that people’s consent was requested and respected by staff. A relative said, “The staff here know what [loved one] likes, and they are very supportive.”

Staff had been trained and could tell us what the Mental Capacity Act 2005 was, and the importance of assuming a person had capacity to make decisions in the first instance. Legislation was followed when people lacked the capacity to make a specific decision such as, the use of bed rails to reduce the risk of falling out of bed. When this was required, the decision was made in the person’s best interests with the relevant people.