Croft House Rest Home

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• 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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Assessments were conducted to take account of people’s health and wellbeing needs, and these were reviewed monthly. However, some gaps were noted, for example around the management of diabetes, and management of how to address leg swelling. People said they were involved in their assessments and knew they could see their care plan if they wished to.

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.

Staff had good knowledge about people’s nutritional needs and people were supported well when they had a specialist diet. Food was prepared in an appetising manner when people were required to have a pureed diet due to choking risks.

The service used nationally recognised assessment tools to consider conditions such as risk of weight loss and malnutrition, risk of skin damage, and risk of falls.

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.

There was effective information sharing between the staff team, using handover time and team meetings. Staff also shared information to wider health teams and made referrals to specialists when required. People spoke of different professionals visiting them, 1 person said, “The staff work as a team; I see a chiropodist that comes to the home. The optician comes here; I don’t wish to see the dentist. One of the girls cuts my hair. They have a doctor that comes here.”

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.

All meals were freshly prepared on site and there was a good amount of fresh fruit and vegetables available. People enjoyed their meals and confirmed they had choices and portion sizes were ideal. A person told us, “It is excellent, I like most of the meals especially Sunday dinner. I get enough to eat; I sometimes ask for another pudding if there is any leftover.”

The provider employed an activities co-ordinator and people were supported to participate in different leisure and exercise activities. A person said, “We get a weekly programme of events in each of our rooms, and you can decide if you want to take part.” People said they enjoyed walks, armchair exercises and games such as bingo.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Staff did not always record they were monitoring different aspects of people’s health conditions, which meant issues or concerns in health outcomes could be missed. For example, we did not find evidence of monitoring bowel health for 1 person that required this to manage their health. Although staff recorded people’s weights to monitor risk of malnutrition, this had not occurred in the month prior to the assessment. However, staff recorded people’s food and fluid intake, and to what level food and drink was pureed or thickened to manage choking risks.

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

Staff undertook training around the Mental Capacity Act 2005 (MCA) and understood the principles of consent. There were MCA assessments and best interests’ decisions recorded in people’s care plans and also consent records where appropriate. This was an improvement following the previous assessment.