Cliff Court 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 feedback confirmed this.

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, wellbeing and communication needs with them. Before people moved into the home a full assessment of their needs was completed to ensure these could be met at the home. People’s relatives told us they were involved in these decisions and discussions about care needs. They were updated and involved in decisions about changes to people’s care needs where appropriate. People’s needs were continually reviewed and their care and support was updated as their needs changed. Although this was not always clearly recorded, staff were aware of people’s needs and this ensured appropriate care and support was provided.

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. Records showed the use of nationally recognised tools for example the Waterlow score for assessing people’s risk of pressure damage and 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 care and support needs were regularly reviewed and staff were aware of any changes. However, care plans and risk assessments did not always include details of the most current support required. The provider told us work was ongoing to address this.

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. People’s relatives told us staff worked together with other teams to ensure their loved ones received the appropriate care and support. Care plans and records showed that referrals and ongoing discussions took place regarding people’s health and social care needs. Staff told us how they worked together as a team to ensure people received the care and support they needed in a homely environment. One staff member described this by saying, “We know exactly what we have to do, we don't even have to speak.” Staff told us how they were updated about people’s support needs at handover and throughout the shift. Staff also worked across roles when required to ensure the service ran smoothly. We saw evidence of this during our visits.

Staff supported people to manage their health and wellbeing to maximise their independence, choice and control. People were supported to stay healthy. Relatives told us their loved ones were supported to maintain and improve their health. One relative told us if they notice their loved one is unwell they will report to staff, they added, “However by the time we mention it, the doctor has already been notified or has visited.” Staff had a good understanding of people’s health needs and when to contact the relevant health professionals. They told us people attended regular health appointments for example, optician and chiropodist. Health professionals told us that they were contacted in a timely way and appropriately when people were unwell. They said that staff followed their advice, guidance and treatment to help improve people’s health and well-being. One healthcare professional told us staff had asked for advice about managing a person’s skin integrity. The healthcare professional said, “They (staff) are being really proactive in monitoring it. I don't have any concerns.” Peoples’ records showed that referrals and ongoing discussions took place regarding people’s health and social care needs.

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’s relatives told us that their loved one’s health and well-being had improved since they moved into the home. They told us this was because they were receiving consistent care and support, they were supported to maintain good nutrition and were kept safe. People’s relatives said staff were attentive to any changes in their loved one’s needs and changes to care and support were implemented when required. There were systems in place to regularly monitor people’s care and treatment to improve outcomes and ensure the appropriate care was being provided. Staff knew people well and monitored them throughout each day they were able to identify when any changes in people’s health and well-being. For example, staff told us skin integrity was checked when personal and continence care was being given. If any concerns were identified the management team or relevant health and social care professionals were informed and support requested. Although staff knew people well and this helped to ensure outcomes for people were positive, improvements were needed to ensure all records included the most relevant and up to date information.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. 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. Where people were deemed not to have capacity Mental Capacity Assessments (MCA) had not been developed and recorded in a decision specific way. Work had commenced to address this and newer assessments demonstrated the involvement of people, their relatives and how decisions were made in people’s best interests. However, further time is needed for this to be fully implemented and embedded into daily practice. We asked staff about decisions that had been made without evidence of MCA’s or best interest decisions, for example the use of shared rooms and sensor mats. Staff were able to tell us how and why the decisions had been made and who was involved. This demonstrated staff were aware of ensuring decisions made involved people, families and were in people’s best interests. Throughout our visit we observed staff asking people’s consent and offering choices before they provided care and support. 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.