The Old Rectory

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.

People's health and social needs had been assessed before coming to live at the service; the impact of these had been fully considered and there was information about what was important to people and their families and how they would like their care and support to be delivered. This had ensured the service could meet the identified needs of the person and that staff had the necessary training to keep them safe and well. Many of the people had lived at The Old Rectory for a long while. One person told us that he and 3 others had lived together at another service before moving in over 20 years ago.

People were assigned ‘key workers’, these were staff members with specific responsibility for the person. Staff therefore quickly got to know people well and were able to provide them with the support they needed. After moving in there were regular reviews with the person, their relatives or advocates and staff. Any issues were addressed, and care plans and risk assessments were updated as required. Monthly reviews of people’s care and support were undertaken, which would be more frequent in the event of an incident or illness or if a person had spent some time in hospital. There was evidence of people being involved in their reviews and these were recorded in the ‘outcome star’ and ‘my meeting’ section of the care plan.

People’s communication needs were assessed regularly and different methods of communication tried and reviewed to ensure people were offered every opportunity to participate in their care decisions. People’s care records were reviewed regularly to ensure they remained an accurate reflection of people’s needs. The provider's processes for assessing and reviewing people's care and support needs were robust. People's assessments included sufficient detail about their individual care needs and preferences, which had ensured their needs were met consistently and effectively.

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.

Recognised assessment and monitoring tools were used appropriately to track improvements or concerns. The management team had oversight of these and planned action appropriately with the involvement of family and the staff team. The service had links with other organisations such as continence community team, physiotherapy teams, learning disability community team and speech and language therapists (SaLT). People's GPs visited the home regularly to check on people’s health and welfare. This meant that matters could be raised quickly, and the home had easy access to the surgery in between these visits if there were any emergencies so they could be responded to immediately.

Staff were given training which followed current good practice guidance. Staff told us how they worked alongside the GPs, social workers and other health and social care professionals to ensure referrals were made and any recommendations were acted upon. For example, people’s ability to eat safely and maintain a healthy weight were assessed and monitored and appropriate action taken. Staff were knowledgeable regarding people’s nutritional requirements, and this was clearly recorded to ensure all changes were shared. Information was available in the kitchen to ensure people received appropriate drinks, meals and snacks. For one person who experienced difficulty in chewing due to dental problems, specific meals that were easy to eat were provided. There were also people who required thickener added to their fluids to ensure it didn’t make them cough. Staff followed health professionals’ advice that ensured people received effective care.

Some people lived with epilepsy, and we saw that advice was sought from specialists and staff monitored their health for signs of seizures and looked for possible triggers, such as bowel management and infections.

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.

The service arranged appointments for people including the dentist, chiropodist, physiotherapists and occupational therapists as required. Care plans contained summary documents highlighting people’s support needs that were immediately available to visiting professionals.

People received the professional support needed which was in line with the ‘right care’ element of positive care for people living with a learning disability and promoted their human rights in receiving equitable care and support. One family member said there were good lines of communication, and they were kept informed whenever their loved ones had appointments or in the event of an emergency when, for example, people had to be taken to hospital.

Health professionals confirmed that staff and the management team had worked alongside them in making improvements to people’s life.

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.

The care staff cooked for people daily and were aware of people’s dietary needs and requirements. People chose their meals weekly at a ‘your voice’ meeting and these were put into a displayed menu. There were charts on the wall of the kitchens that showed allergies, likes, dislikes and special requirements, for example those requiring a soft diet. The kitchens were clean and well equipped. Temperature checks of food and equipment were carried out and recorded. People and staff went going to a local supermarket to choose food rather that delivery for the week, so people could be more involved in the meal-time experience. Fresh fruit and vegetables were readily available. Staff and people talked of producing their own vegetables and there were plans for this to happen. Some people were growing herbs and had plans for potatoes.

We saw staff supporting people during mealtimes, offering to cut up food, explaining to people whose vision was impaired what food was on their plate and where it was placed. They prompted people to eat, spoke kindly to people and made them feel comfortable. For those people who preferred or needed to eat alone, staff supported them to enjoy their meal.

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 health and care needs were monitored and records kept using recognised systems of measurement. For example, the use of recognised tools to measure and monitor people’s health and well-being. For example, nutrition and skin. People’s weights were regularly checked with their consent and records kept.

Care plans contained a well-being section which provided details of all medical conditions, appointments and interventions people had experienced. Relatives and health professionals told us that staff knew people well and they were able to detect subtle changes in people’s presentation which allowed early interventions to make sure people received the best possible care. For example, staff told us that they had one person expressed discomfort by certain signs which they immediately acted on and contacted the GP to commence antibiotics.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff were observed knocking on people’s doors and when asked, had good knowledge on seeking consent before offering support and delivering care.

All staff had received up to date training on the Mental Capacity Act (MCA).Staff demonstrated an understanding of the Mental Capacity Act 2005 and confirmed they had completed relevant training to support the people appropriately. Staff said the people were encouraged and supported to have choice and control over their day to lives. Staff commented," We listen to them and give them choices, involving them in everyday decisions, and encouraging their independence while making sure they are safe."

We observed that people were offered choice throughout the inspection. This included what they wanted to do, what they wanted to eat or drink and how they wanted to be supported.