Hylands House 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 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.

People and their relatives were encouraged to complete an ‘all about me’ booklet, so staff could understand people's history, identity and what was important to them.

The registered manager or the provider’s operations manager assessed people prior to admission to ensure that the service could safely meet their needs. Essential care plans and risk assessments were created prior to people's admission to the home and further developed as managers and staff got to know people.

Staff said they had the information they needed to provide safe and effective care on the day people arrived in the home. Systems were in place to ensure staff were made aware of any updates as people's needs changed. Records reviewed reflected that staff were delivering care as described in people’s care plans.

Relatives said they had not seen their loved one’s care plans, however, they felt confident any concerns, or changes in needs, were communicated to them regularly.

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 service worked well with external health providers to ensure care being delivered was in line with current guidelines and promoted good outcomes for people. One relative told us how their loved one’s health had been declining rapidly prior to admission but since moving to the home had become more stable. The relative felt this was due to the care and support the person was receiving.

The provider used recognised tools to assess, and monitor people’s risks around nutrition and hydration, falling and skin integrity. This ensured people’s care and support was planned and delivered in an evidence-based way. We reviewed people’s records and found these tools were being used effectively, with appropriate actions taken where concerns had been identified. People’s nutritional needs and risks were assessed and identified. Care records provided staff with guidance on how to ensure people had enough to eat and drink to maintain their health and mitigate any identified risks.

Catering staff described good communication, so they had the information required to meet people’s nutritional needs. This included when people needed extra calories added to their meals to prevent weight loss or their meals modified because of a risk of choking.

Staff told us their training was refreshed annually to ensure their knowledge remained relevant and reflected up to date guidance. The registered manager had sourced additional training for staff including end of life care, oral health and sepsis, when needs had been identified.

We were told of an example when staff had used this training to identify early warning signs of sepsis for 1 person, and compliments seen reflected that this person’s family felt prompt action by staff had saved the person’s life.

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 other services to achieve positive outcomes for people. One healthcare professional told us the registered manager was always very responsive and followed their advice to meet people’s clinical needs.

Staff told us communication in the home was good and that there was a handover of information between shifts. Messages and alerts via the electronic care planning system meant the provider was assured that all staff had received important information they wished to share with them. Guidance and advice from external healthcare professionals was recorded in people’s care records

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 effectively supported to access healthcare services and received ongoing healthcare support. Care records showed people were referred to a range of health and social care professionals such as doctors, diabetic nurses, frailty nurses, chiropodists, opticians and dentists.

The provider recognised that poor oral health could impact on people’s health, their ability to eat and their ability to verbally communicate. Care plans described the support people needed to maintain their oral health and every person in the home had access to a community dentist. Regular checks were carried out to ensure people were receiving the oral healthcare outlined in their care plans.

Staff told us of recent oral health training they had received and felt it had improved their practice.

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.

People were reviewed regularly, through weekly ward rounds with their GP or a frailty nurse and information shared was included in care plans. This meant staff were clear about people’s medical conditions and the signs that might indicate a deterioration in their health.

For example, 1 person was diabetic. There was detailed guidance in their care plan, about the signs of high or low blood sugars and the immediate actions staff needed to take to provide effective support at such times.

When a need was identified, records were kept for monitoring food and fluid intake, catheter care and when people needed to be repositioned to prevent skin damage. This ensured people’s needs were met to achieve positive outcomes.

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

Staff understood the importance of promoting and supporting people to make as many of their own choices and decisions as possible. For example, we saw staff asking people where they wanted to eat their meals and where they would like to sit. Staff told us they encouraged people to accept the care being offered but would ultimately respect people's right to decline support. One staff member explained, “I might just go out the room for a bit and then try again. If they decline, then I would ask another carer to try but I never force them.” Another said, “It’s about explaining what needs to happen, being patient and giving people time.”

Where people lacked the capacity to consent to decisions, Mental Capacity Act assessments and best interest decisions were completed. Capacity assessments outlined how people had been given the best opportunity to understand decisions to be made and who had been consulted in the decision making processes. This helped ensure decisions made were in people’s best interests.