St Anne's Care 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 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 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 ensured people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Relatives confirmed they felt involved in people’s care. One relative said, “I have always been involved in [person’s] care plan and informed of any changes.” Another relative told us, “The staff have asked me what [person] likes to do and I do feel they would support [person] to remain independent in those areas.”

People’s care needs were assessed and care plans reviewed.These contained information about people’s physical and mental health needs, communication needs, and how to achieve their preferred outcomes.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them.

People’s nutrition and hydration needs, including information on food allergies and preferences, were assessed and documented. Relevant information about people’s dietary needs and requirements was also accessible in the kitchen. The menu was displayed in the service to inform people of their choices.

Overall relatives were complimentary about the food offered at the service. One relative said, “I believe that [person] is helped and encouraged to eat their meals and is often supplied with drinks and snacks.” Another relative said, “The menu here is brilliant. Teatime often is very good, but food is stone cold sometimes during teatime when I am here.”

We observed staff supporting people with their meals in line with their assessed needs.

The service 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.

Relatives told us they were kept informed and felt involved in their family members’ care. One relative told us, “I receive calls from time to time regarding [person’s] care and am able to discuss this with the staff.” Another relative said, “I am advised of any changes being made.”

Health and social care professionals were complimentary about working with the service. Comments included, “The home have provided detailed risk assessments and guides to demonstrate how they aim to meet [person’s] needs effectively, which has provided [person’s] family reassurance and has given us confidence, that the move will be given the best possible chance of succeeding”, and “I have found the staff and managers to be proactive and communicate in an appropriate and caring manner about the individual.”

Staff confirmed they had access to the provider’s electronic care planning system and had enough information on how to support people. A staff member said, “We have been given enough information needed to look after the residents with their complex behaviour, diabetes and swallowing difficulties. We have training in these areas, and the information is available in people’s care plans.”

Records of visits and correspondence from health and social care professionals were documented on the provider’s electronic system. This meant staff were able to easily access information on people’s health needs.

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.

Staff confirmed they knew how to support people to live healthier lives and prevent deterioration. One staff member told us, “The [senior colleagues] regularly speak to GPs for medication reviews and if residents are unwell, andDistrict Nurses for wound treatment and catheter care.” Another staff member said, “I am aware of the resident's health issues (they are written in their care plan) and any important changes, risks and information are normally well communicated and handed over.”

Records confirmed the service worked with external health and social care professionals, including social workers, the community mental health team, dieticians, and nurses.

The service 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.

Daily records showed the service monitored the care and support provided to people to ensure it remained effective. When necessary, the electronic care planning system was used to record and monitor people’s outcomes, such as their fluid and nutrition intake.

One relative said, “There are jugs of juice readily available in [person’s] room, in the lounge and they are offered hot drinks frequently.”

Staff confirmed they monitored people’s health and knew how to escalate concerns if people’s condition changed. A staff member said, “We contact the family always if there have been any changes to people’s health or there has been a fall or any concerns, the [senior colleagues] always contact the family.”

The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Where necessary, people with legal authority or responsibility can make decisions within the requirements of the MCA. The provider did not have an overview of who could lawfully act on a person’s behalf which meant that some relatives had provided consent on behalf of people and there was no evidence they had the legal right to make those decisions. The registered manager responded to our feedback and sought the necessary documentation from relatives.

Staff confirmed they understood the importance of consent and how to encourage people to make their own decisions.One staff member said, “We make a best interest decision using the least restrictive option.” Another staff member told us, “The carer should encourage residents to make decisions for those who have capacity. The best interest approach should be adopted in making the least restrictive decision for those who have been assessed not to have capacity. For example, a resident who has decided to wake up at 6am to have his shower should be supported to do so if he has the capacity to make the decision, even if that is not captured in his support plan.”

Some MCA records were dated and had not been reviewed in line with good practice. People did not have MCA assessments for all decisions as required. The registered manager did not have an effective oversight of MCA assessments for people at the service. In response to our feedback the registered manager started the process of reviewing all MCA assessments to ensure people’s right were respected and MCA assessments in place have been reviewed.