Chetwynd House

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 63 (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. Care plans were not updated consistently. For example, we saw 1 person’s care plan had been updated to include changes to their behaviour and increased periods of anxiety. However, the care plan did not include any guidance for staff about triggers for this behaviour or how the person should be supported during this time. Additionally, some parts of the care plan stated the person did not experience any period of stress or anxiety. This placed the person at risk of harm from not receiving appropriate care and support as staff received mix guidance about the person’s condition. Despite this there was no evidence that anyone had come to harm. Staff we spoke to were knowledgeable about people’s current needs despite the lack of written guidance. One staff member said, “Some care plans aren’t fully up to date, but I know how to support people, I know what their wishes are, and we [staff] communicate this to each other. We have hand overs and meetings, so nothing gets missed. We pride ourselves on the level of care we deliver to people.” People living at the home also supported this. One person said, “I haven’t seen my care plan, but I have no concerns. Staff know me well and look after me even better.”

Despite the inconsistencies documented in care plans, 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. For example, the provider had a large stock of equipment such as airflow mattresses available so when peoples need changed or during periods of illness they did not have to wait for external referrals and equipment being ordered before their care needs were supported. This had led to a decrease in the occurrence of injury relating to skin integrity and reduce people’s recuperation time from pressure damage.

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. During the assessment we observed staff working in partnership with external professionals such as district nurses to support people’s needs. Staff were knowledgeable about needs, wishes and conditions and where appropriate supported people to communicate this when needed. People we spoke with said staff supported them to access services and appointments as needed. One person said, “Staff will always help me see a doctor if I ask and I go to the dentist when needed.”

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. People had access to activities which promoted their wellbeing. Where people wished to improve their mobility and independence there was exercise groups available as well as bespoke 1-1 support with staff. People were offered variations in food where needed such as low sugar or low-calorie options to support diabetes and weight management.

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. As descried under safe, care plans did not always give staff clear guidance on how to monitor an improve people’s outcomes in areas such as pressure care. Reviews of care plans had not been consistently undertaken and recommendation by professional were not always recorded therefore there was no evidence people’s care, and their known risks were safely or effectively monitored.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Care plans did not detail how people and their loved ones were included in their care planning or reviews. People who had capacity told us they had been verbally included in planning their care with staff. However, where people lacked capacity, it was not always clear who had been included to support the person with decision making and care planning or in what capacity.