Bush 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 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.

The provider had systems in place to assess people’s needs and develop care plans to meet them. People and where appropriate their relatives were involved in assessments and care plans. A relative told us, “It’s been phenomenal. [Person’s name] went in there from hospital; they were discharged there without us seeing it. Staff had been given completely wrong information about them, by the hospital so we went through it all again with the staff. They have really looked after [person’s name].” Staff told us they had access to information about people before admission which helped them meet peoples needs and keep them safe, staff said care plans were reviewed over time as they got to know people. The manager told us they completed a new assessment after they received a and they also received a support plan from the local commissioners. The assessment was undertaken and then if they could meet people’s needs, the person and their relatives were invited to the service for a visit, and the risk assessment and care plan was put in place ahead of the admission. Assessments and care plans were in the system and there were regular reviews to ensure accuracy, however some minor inconsistencies were found in some areas of the care plans, which the manager agreed to immediately address.

The provider planned and delivered people’s care in line with legislation and current evidence-based good practice and standards. The manager told us they used a range of tools to support them to assess risks to people. Staff told us they were aware of the guidance included in peoples plans and used this to inform how they supported people. For example, we saw tools were in place to identify risks to people in relation to their weight and skin integrity and these were used to inform care plans to guide staff on supporting people effectively.

The provider had systems in place to support staff to work together to meet people’s needs and they worked with other agencies when needed to ensure people had effective support. The manager told us they worked in partnership with the district nurses to ensure people living with diabetes had clear guidance in place for staff on how to support them to manage their condition. Staff told us the electronic records system in place ensured they had information about people’s needs and were able to work together and with other agencies to ensure people received the care they needed.

The provider supported people to manage their health and wellbeing. People were supported to access health professionals advice and have their health monitored. A relative told us, “The staff are monitoring [person’s name] weight. They have recently been diagnosed with a health condition which can cause weight loss.” Staff told us they understood people’s health needs and were aware of how to support people to manage their health conditions. We saw people had specific care plans in place which set out how they needed to be supported to manage health conditions, and these had been developed with information from relevant health professionals. People were supported to seek medical assistance when needed and we saw staff followed the advice which was given.

The provider had systems in place to monitor people’s care and review their care plans. People and their relatives spoke positively about the service and the impact it had on people’s care needs. A relative told us, “[Person’s name] has improved since changing room. They are now eating better and have gained weight. We can see it and they have told us. [Person’s name] didn’t used to shower but now with their encouragement they are 3-4 times a week. They are eating better.” Leaders told us people and relatives were engaged in their care plan reviews, through chatting and this was documented in the care plan. Care plans were reviewed monthly and updated to show changes in people’s needs and staff were aware when things changed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The provider had a system in place to assess people’s capacity and document decisions taken in people’s best interests. Staff used the information to guide them in how they supported people to make decisions. Staff had received training in the mental capacity act and were observed seeking consent from people. We saw staff seek consent and where this was declined the person’s wishes were observed.