Worplesdon View

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 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, wellbeing and communication needs with them.

Pre-assessment were completed with people prior to offering them a place at Worplesdon View. This was to ensure that staff had the right skills and training for people’s needs and that the service would be the most appropriate place for them to live. Staff told us, “We stopped 2 people coming in last month as we didn’t have sufficient skills within the staff team to meet their needs.” This demonstrated the provider carefully considered whether the service could meet people's individual needs and provide the right level of care and support before offering them a place.

A person told us, “I remember having a very thorough assessment when I first moved here” and a relative said, “From the very first moment [person] loved the place and soon after decided to stay there on a permanent basis and not return home.”

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.

Staff used various national assessment tools to determine baselines for people and to identify areas that may require further input or monitoring by staff or external health professionals. This included weighing people regularly and calculating their MUST (malnutrition risk score), carrying out GULP assessments (to assess people’s risk of swallowing difficulties) and Waterlow check lists (to determine a person’s risk in relation to their skin integrity).

These tools helped ensure monitoring was proportionate to people's needs. They reduced unnecessary checks and record-keeping and enabled staff to focus on what mattered most to each person. For example, 1 person's GULP assessment identified they were not at risk of dehydration, so staff did not routinely monitor and record their fluid intake.

One person moved into the service with low body weight, numerous pressure wounds and multiple long-term health conditions. However, through early assessment and evidence based care together with a coordinated and proactive approach within 3 months of the person living at the service they improved enormously, with their pressure wounds fully healing and their weight increasing.

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.

Staff worked well together internally as well as with external professionals and health care providers. Throughout the day we observed staff liaising with each other to check that tasks had been undertaken or where support was needed it was arranged. An external health professional told us, “The team know me so well and I am able to give information to them for them to continue to support the resident in the way I recommend in between my sessions. Having been coming for so long, I feel like I am part of the team.”

The service worked closely with the surgery and a GP visited the service each week to review anyone that staff considered needed to be seen. Other external services included the speech and language therapy team and dental services. All helped to ensure people received the right input from the right professional when they needed it.

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 were offered a wide range of foods and drinks and where people had swallowing difficulties food was prepared in a way that was suitable and safe for them. Staff weighed people monthly (or more often if they were at risk of losing weight) and sought a doctor’s input should staff identify signs of malnutrition. At this stage foods were fortified or additional calorific snacks were offered to help people maintain or regain a healthy weight. A relative told us, “They will go over and above and make a point of visiting [person] outside of the normal care or nursing needs and will encourage [person] to drink and if [person] hasn't eaten her food. They will offer [person] something they know she really likes.”

Other people had the involvement of health care professionals to help maintain their health. This included where 1 person had the input from a physiotherapist in relation to their mobility and safe transfers.

As part of the weekly activities programme, staff provided regular exercise sessions and quizzes. These activities encouraged people to remain physically active while also supporting their mental wellbeing as well as providing opportunities for social interaction.

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.

Staff monitored people effectively and they helped to prevent the deterioration of people wherever possible. One person was being monitored for their weight loss. Nutritional supplements had been prescribed and a modified diet which was easier for them to eat. There was evidence the GP had been involved and the chef was also involved in their nutritional care plan review. One to one support was provided during mealtimes and weekly weighing introduced. As a result the person gained some weight and remained clinical stable.

Other people had moved into the service, or been discharged from hospital with skin breakdown or pressure wounds. Staff introduced suitable equipment, such as an airflow mattress and repositioning regimes. This helped prevent further skin breakdown and with staff following an individualised wound care plan, ensured people recovered from their pressure sores. One person told us, “When I came here I had bandages on both my legs but now that has all stopped. I have had the physio come in regularly and it has all worked.”

Staff were good at identifying changes in people. One staff member told us, “If we find anything at all, a little scratch or bruise or not feeling well, not eating or sleeping we report straight to the nurse. For example, when [person] talks more, particularly about animals we know she’s unwell, usually with an infection.”

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

Staff understood the principles of the Mental Capacity Act 2005 (MCA). The service had identified a lawful basis for the use of CCTV and had placed it in some (limited) internal and external areas to support the safety and security of people, staff and visitors. Although we did not find evidence of capacity assessments or best interests decisions being made for people who lacked capacity we discussed with the registered manager the importance of considering the MCA principles when CCTV is used, including whether people have capacity to understand and consent to its use and, where they lack capacity, whether its use is in their best interests and is the least restrictive option.

In other aspects of people’s care, we found detailed capacity assessments and best interests discussions and decisions. These covered medicines, locked doors, living at the service, bed rails and sensor mats. It was also clear that relatives had been involved in these discussions.

Staff were able to describe the meaning of the MCA with 1 telling us, “We assume they have capacity and if not we assess this and do a best interest decision.”