Sovereign 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 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 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 provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Some people told us their care and support needs were discussed and assessed before they came to live at the home. One person told us, “We had a long discussion initially and I was asked a lot of questions. It was all very smooth no problems whatsoever.” A relative told us, “We had a meeting here initially to discuss everything.”

Staff used care plans to help them meet people’s needs in ways they preferred.

Assessment records included information about any known risks to people’s health. They included information about people’s health, medication, communication and their wishes for future care. Care plans were developed based on people’s assessed and ongoing needs. People had regular check-ups with health and social care professionals to help maintain their health and wellbeing.

The provider planned and delivered people’s care and treatment with them where possible, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People told us staff knew what they were doing when supporting them. One person said, “I think they do know what I need.” We saw at lunchtime some people were provided with their meals in their rooms supported by staff where needed. Specialist diets and food consistencies (such as thickened fluids, soft foods) were known by staff so they could support people safely. In the dining area people were provided with meals and drinks of their choice to meet their nutritional needs.

A range of clinical tools were used to assess people’s needs and level of risk to help improve people’s outcomes. This included a nutritional tool to identify those who may be at risk of malnutrition. Guidance was in place for staff to follow to manage people’s nutritional needs which included regular weight monitoring. Any concerns were referred to other healthcare professionals to help ensure people received the support they needed. Any guidance given was included in people’s care records so that it could be followed by staff.

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.

People spoke positively about all of the staff and the support they received.

Staff worked across all areas of the home so that they got to know people well and could support them effectively. Staff understood the importance of good communication between them and told us they were kept informed of any changes during the daily handover meetings and via the electronic app they used. One staff member said, “The nurses will help us if we need anything.”

People’s daily notes completed by staff showed when healthcare professionals had visited to discuss a person’s care so all staff could read about any updates and keep themselves informed of any changes to the person’s care.

The registered manager told us, “If they (people) need to go to hospital we do a hospital pack that gives a handover of the persons baseline. We will call the nursing home or hospital and give a handover and ask if they have any questions. Two nurses sign out medication.”

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 told us how staff supported them to complete tasks independently to help support their wellbeing and health. People also told us they were able to access health professionals when needed to maintain their health. One person told us, “I’ve seen the doctor once….They do checks on me, weigh me and take my temperature.”

Care records included information of people’s health conditions and contact details for the appropriate healthcare professional, if the nursing team needed them. Staff confirmed they had the information they needed to care for people effectively.

Care staff told us they felt able to report any changes in a person’s health to the nurse or senior staff member in charge and were confident these would be acted on.

People had opportunities to join in activities provided by the home or use the gardens to help maintain their wellbeing.

The provider had arrangements in place to monitor people’s care and treatment to continuously improve it. Outcomes were not always consistently recorded to show they met clinical expectations.

Records to monitor people’s care and support were in place and included repositioning charts for people at risk of skin damage. We found 2 people had not been repositioned in accordance with instructions which placed these people at risk of skin damage. The registered manager said this would be addressed. We did not identify any significant impact as a result of this.

People felt that staff knew about their care and recognised when they may need additional support.

Staff were able to explain how they monitored people’s health and wellbeing to improve outcomes. Staff understood what action to take if they identified a concern. One staff member told us, “We monitor [Name] urine output to check there’s no problems with their catheter. I would report any pain, odour or blockages to the nurse and record in the notes.”

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

Staff spoken with told us they had received mental capacity training and said they understood the importance of explaining what they were doing on a day-to-day basis in relation to personal care before gaining people’s consent. One staff member told us, “We ask consent, we have to explain first what we are going to do.”

Care records detailed if people had capacity to make day to day decisions or not, and if this was not the case, how to ensure the person was supported.

The registered manager told us in relation to peoples human rights, “Everyone is given choice, most have capacity, and we ensure their opinions matter, they get a menu choice every day…. We give them the right to refuse personal care, we tell them risks, it’s up to those with capacity. We work in residents best interests and complete an MCA (mental capacity assessment) to gain information.” They went on to explain they made a referral to the relevant authority for a DOLS (deprivation of liberty safeguard) if needed ensuring family and GP were involved.