Melford Court Care Home

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 inspection we rated this key question good. At this inspection 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, well-being and communication needs with them.

People were assessed prior to moving into the service. These assessments included consideration of people’s physical and mental health, communication needs, mobility, nutrition and hydration, and any cultural or personal preferences important to them.

Care plans were reviewed when people’s needs changed. Staff demonstrated a good understanding of their responsibilities in keeping care plans updated and reflective of people’s current needs.

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.

The leadership team and nursing staff used clinical assessment tools to assess, monitor and review people’s needs and levels of risk. External professionals, including GPs, were involved in reviews of people’s health. One visiting professional told us, “The registered manager and deputy manager run a tight shift!”

The staff team consistently monitored people’s healthcare needs using nationally recognised assessment tools. Records showed, for example, that the Malnutrition Universal Screening Tool (MUST) was used to identify people at risk of weight loss and to determine when referrals to other professionals were required. When risks were identified, staff took appropriate action to reduce these and support people’s well-being.

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 provider worked with a range of health professionals, including the local GP practice and the Speech and Language Therapy (SALT) team to support people’s care and treatment. Referrals were made when needed, and staff followed up on actions agreed with external professionals.

Staff worked well together to share information and plan care. They told us they had access to care plans; however, they would also benefit from more handheld care recording devices which would help them provide more detailed records and therefore consistent support. The registered manager was aware of this and had raised it with the nominated individual who assured us additional devices alongside a new care planning system was imminent. Staff told us communication within the team was effective and that information about people’s needs was shared with them promptly.

The provider supported people to manage their health and well-being 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.

Staff we spoke with had a good understanding of people’s health needs. For example, they knew which people were living with diabetes and were aware of when to escalate concerns and the steps to take if this happened.

Staff monitored people’s health and escalated concerns appropriately.One person told us, “I came from hospital had a nasty [pressure ulcer] but it has nearly gone. When I came to Melford Court I was not eating, I [had lost a lot of weight] but here they make me high protein meals. The kitchen they are very good at making food with intense taste to tempt me as my taste buds had gone, they are fortifying my milkshake and bring me an extra one.”

The lunchtime meal was a positive experience with appetising food, good presentation and staff offering choices and alternatives that met people’s dietary needs, including modified textures and additional fortification when required. People enjoyed meals and engaged positively with staff. One person told us, “The vegetarians are catered for, we get plenty of drinks. You can ask for a ham salad or ham egg and chips – they are very accommodating if you don’t want what is on the menu.” Another person said, “The food it is good, we get enough variety, all the meals are good, I can just go and help myself to fruit.” A relative commented, “The food here is wonderful, they have themed days, the food is really nice. The chef does fresh cakes every day and it is like going out to a café.”

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.

Systems and processes were in place to monitor clinical care outcomes and drive improvement. Leaders and senior staff maintained effective oversight of people’s needs. Records showed that key areas of support such as wounds, weight loss and falls were routinely monitored and analysed. Staff also worked closely with a range of external professionals to support positive outcomes. This collaboration, alongside consistent monitoring, helped ensure people continued to experience effective care.

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

People had mental capacity assessments, DoLS applications and authorisations, and best interest decisions in place for all necessary decisions. DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) documents were in place to ensure staff had all the relevant information. Records showed people were involved in making decisions made about their care. Staff consistently sought consent before delivering any care or support. They took time to explain planned actions, offered clear choices, and respected people’s decisions, ensuring care was delivered lawfully and in a way that upheld each person’s autonomy. Throughout the inspection, we observed staff providing information using communication methods suited to each individual’s needs. People we spoke with confirmed staff always checked with them before providing support.

Staff had received training in the Mental Capacity Act 2005 and were confident in applying its principles in day‑to‑day practice. They described how they would support people to make their own decisions, and how they would escalate concerns if they believed a person’s rights under the MCA were not being upheld. Staff told us they always obtained consent before assisting with personal care and were aware of the need to make best-interest decisions only when a person lacked capacity for a specific decision. A member of staff said, “Staff are required to ask for permission for personal care and respect a [person’s] right to say no. If a [person] lacks the capacity to make a decision they must still be involved as much as possible and decisions must be made in their best interests. Unwise decisions - [people] have the right to make decisions that staff and family may view as unwise providing they have the capacity to do so.”