Maldon 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 most people’s feedback confirmed this. The management team worked with people, their relatives and healthcare partners to personalise people’s care and support. The management team advised how they carried out pre-assessments to ensure they were able to meet people’s needs and people were invited into the home to visit to make sure it was the right home for them.

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, well-being and communication needs with them. Before people started using the service a full assessment of their needs had been undertaken to ensure they could be supported at the home. We received some mixed feedback about reviews, for example some relatives felt they were not involved in care plan reviews or there was not enough time in the yearly update review meetings. However, we found care plans were updated yearly and relatives involvement document in the ones that we viewed. Reviews reflected people’s individual needs, and all staff were aware of any changes to people’s care needs. People’s care plans were personalised to their specific needs such as some had Makaton and objects of reference. People had Positive Behaviour Support plans (PBS) which included how best to reassure and support someone if they were distressed. Relatives told us people’s care and support needs were reviewed. One relative said, "Yes, it is and done annually. If there are any changes to the needs they will try and review it." Another relative told us, "Yes. I think as often as it is needed and kept me informed all the way through. If anything needs amending, then I would say this needs addressing and it is done there and then. They are always happy to meet my expectations."

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. Some people had been identified as needing support when eating and drinking. Assessments had been completed by Speech and Language Therapists (SaLT), and support plans developed from these. These plans included ensuring people were supervised when eating to prevent the risk of choking and ensuring they ate at a steady pace. We saw staff providing this support appropriately whilst helping people retain their independence and dignity. Records showed the use of nationally recognised tools for example the Malnutrition Universal Screening Tool (MUST) for monitoring people’s weight. Staff received regular training and updates to help ensure they understood the current standards of care to support people effectively. People’s support needs were regularly reviewed, and staff were aware of any changes, and this was reflected in people’s care plans.

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 told us they worked together as a team to ensure people received the support they needed. One staff member said, “We work together, we help each other out.” We saw evidence of this during our visits. Staff told us they were updated about people’s support needs at handover and throughout their shifts. One relative told us, “As a whole we find the current team approachable and friendly, and they seem keen to work there.” Another relative told us, "They are nice people, and my [relative] loves it there."

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. People were supported to stay healthy. They were encouraged to eat a healthy diet and take regular exercise as they were able. Staff had a good understanding of people’s health needs and when to contact the relevant health professionals. Records showed, and staff told us, people attended regular health appointments for example, optician and dentist. People’s records showed that referrals and ongoing discussions took place regarding people’s health and social care needs. If people were unwell they were supported to visit the GP. People were supported to attend routine well-person checks and to attend appointments for monitoring of ongoing health conditions. Each person had a Health Action Plan which included details of their health needs and support they needed to receive the care and treatment they needed.

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. There were systems in place to monitor people’s support and treatment to improve outcomes and ensure this was being provided appropriately. Staff knew people well and monitored them throughout each day and were able to identify when there were any changes in their well-being. If any concerns were identified the management team or relevant health and social care professionals were informed and support requested. Staff knew people well and this helped to ensure outcomes for people were positive. Key worker reviews helped ensure people were able to identify any wishes or goals they may have, and staff supported them to achieve these. For example, one person liked trains and records showed they were regularly able to enjoy a train journey. A relative told us how the home worked together and supported with community health care professionals to achieve a positive outcome for someone living in the home, “Most recently they helped co-ordinate between the GP, myself and the neurologist to sort out [specific medication].”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. The manager told us that previously there were people were deemed not to have capacity, Mental Capacity Assessments (MCA) had not been in place. However, these were now being developed and recorded in a decision specific way. The MCA’s we saw contained the relevant information and demonstrated the involvement of people, their relatives and how decisions were made in people’s best interests. However, further work was needed for these to be completed for everyone and be fully embedded into everyday practice.

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). The service was working within the principles of the MCA, and appropriate legal authorisations were in place when needed to deprive a person of their liberty. Any conditions relating to those authorisations were being met.