Combe Lea Community Resource Centre

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 requires improvement. At this assessment the rating has changed to 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’s needs were assessed comprehensively and care plans reflected health conditions and risks.

Referrals were made to health professionals where appropriate. For example, the registered manager had ensured a referral to the mental health team had been made in order to support a person with their anxieties.

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.

There were processes to manage health related risks. For example, the water low assessment was used to evaluate people’s risk of developing pressure ulcers, and these assessments were reviewed regularly. Referrals were made to health professionals, for example, the reablement team, for support and advice for people who need help moving around and need specialist equipment.

District nurses visit the service daily to carry out any clinical care needed, for example administer insulin, and GP’s visit the service weekly or sooner if requested.

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 confirmed they received detailed handovers. One staff member said “Teamwork is fantastic. We have a handover every morning...”

The registered manager held daily meetings each morning with heads of departments for support and discussions around concerns and people’s health needs.

Feedback from health professionals was positive about the communication with the service. Comments included: “If I have a question about a particular resident, they always know the answer “and “I have seen their handover document between shifts which has a good report of the events recorded”.

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.

Daily activities such as musical bingo, quizzes and yoga had been developed to promote both physical and mental wellbeing. People were supported to make healthy food choices, encouraging a balanced diet. Meals were varied and nutritious. Feedback from relatives highlighted the positive impact of this approach, with one relative saying their relative was now more active, engaged and healthier than before.

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 to monitor known healthcare risks, such as malnutrition and dehydration. We saw records of meals and fluid intake had been made for people. However, for one person at risk of developing a pressure ulcer, repositioning records were not fully completed. This meant there was limited assurance that care was consistently delivered in line with the person’s care plan.

Leaders explained that in some cases people were repositioning themselves and staff had not recorded this. They confirmed that senior staff and managers monitor electronic care records throughout the day and address any gaps with staff to ensure identified care needs were met.

However, care plans were reviewed regularly, and health professionals visited the service to help meet people’s health care needs.

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

The service had made improvements around consent, and the service was now operating in line with the Mental Capacity Act (MCA). Mental capacity assessments were in place, and Deprivation of Liberty Safeguards (DoLS) were managed appropriately.

Staff explained how they sought consent from people before providing support.

Although there were documents relating to consent for people,

during the inspection some inconsistencies were identified. For example, in one person’s MCA documentation, had not recorded other people involved in the decision making. The registered manager told us this had been identified prior to the inspection, and records were being reviewed. We saw a clear action plan had been put in place to make improvements to these records.