Hickling 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 was effective as they did not always assess or review their health, care, wellbeing and communication needs with them.

Although staff demonstrated knowledge of people’s needs, the care plans we reviewed did not always contain sufficient detail to evidence that care was planned and delivered in line with peoples assessed needs.

This meant that staff would not have sufficient guidance to assess people's current needs, however, staff we spoke to from memory recalled a good knowledge of peoples care needs and support. Changes and concerns to care needs were communicated at each shift thoroughly through verbal handovers.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them.

There was evidence that recognised guidance, and tools were used to support peoples care and treatment such as multi- universal screening tool (MUST) for monitoring nutrition and weight, Waterlow to monitor people at risk of developing a pressure ulcer and behaviour support forms. People confirmed that their choices were respected including the preference around the gender of care staff assisting with personal care.

The provider worked well across teams and services to support people. We observed strong teamwork and mutual support across the service and management support in the home 7 days a week.

One staff member said, “There are no frictions, we communicate well on shift” and another explained that “We all work well together and help each other where we can.”

Healthcare professionals told us “I find that they are very proactive in requesting clinical input whenever they have concerns, and are also very proactive in organising medication reviews -for example prompting us to schedule these when they are overdue” and that “referrals to healthcare professionals such as district nurses, dietitians are carried out in a timely manner.”

Staff supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives.

People’s nutritional needs and preferences were assessed and understood by staff. Staff had a good knowledge of peoples likes and dislikes regarding food. One person said “There’s a good selection of food. Yes, I get enough to eat and drink and there’s always a drink here in my room. Or the trolley comes around.”

Staff helped people to access healthcare professionals and relatives were informed quickly when concerns arose. A relative stated that their loved one’s needs are “Definitely met, and they see a GP and Chiropodist regularly.”

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.

We identified that one person became distressed after their family left and there was no documented follow up to check their emotional wellbeing.

Oral hygiene monitoring found that tooth brushing was completed more consistently in the morning than in the evening. This trend was identified but there was no exploration into the reasons for this or a plan to improve evening oral care.

There was a resident of the day initiative in place and relatives gave us positive feedback about this, telling us that they were included in the updates to their loved one's care needs. One relative said “Completely involved. I know what they do for her and I’m kept in the loop.”

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

The staff had received training around the Mental Capacity Act 2005 and when asked some staff demonstrated an understanding of the principles. However, 2 of the 3 care plans we reviewed did not evidence how a conclusion had been made about the assessment, demonstrating that training was not consistently translated in to practice. The registered manager planned to address this.

We observed people were given choices when entering rooms, to assist with care and administering medication. A person living in the home said, “I regularly am asked for consent and always have choices.”