Adalah Residential Rest Home Limited

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 inspection we rated this key question good. At this assessment the rating for this key question has remained good. This meant people's outcomes were consistently good, and people's feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most relatives we spoke to felt involved in the planning of their relative’s care and support needs. A relative told us, “Care plan is up to date, we – and I mean we - review it every year. They’re really good and objective. It includes end of life care plans and an instruction for DNAR.” However, a relative told us, “Care plan? Not sure but we’re meeting with the manager next week to discuss her future care” and “[relative’s] care plan hasn’t been reviewed formally for quite a while but it’s actually under constant review as their needs change.” While most people and relatives we spoke to expressed that they were generally happy with their care, our assessment found elements of assessing needs did not meet the expected standards.

The registered manager told us they carried out a full assessment of people’s needs before they came to the service to ensure their needs could be met. This involved meeting people and getting feedback from health professionals involved in the person’s care. However, we found systems in place for when people transition into the service were not always robust.

Not all care plans and risk assessments were personalised, and support was not always in line with people’s care plan. Records we looked at failed to demonstrate people’s needs were being regularly reviewed through assessment to ensure their support plans continued to reflect their needs.

People told us they had enough to eat and drink at the service. A person told us, “If I wanted more, they always offer it to me. They always give us 2 options and we can choose what we want.” While the people we spoke to expressed that they were generally happy with their treatment, our assessment found elements of their treatment did not meet the expected standards.

Staff knew people well and how they wished to be supported with food and drink. People were given options at mealtimes and were able to choose what they wanted to eat.

People's care plans and risk assessments were not always personalised, and support was not always in line with people’s care plan. Records we looked at failed to demonstrate people’s needs were reviewed through assessment to ensure their support plans continued to reflect their needs. The registered manager did not carry out a care plan audit.

Consent to care and treatment was sought in line with legislation and guidance. People we spoke with told us they were able to make some informed choices. For example, the times they like to get up in the morning and go to bed, what clothes they like to wear, choice of meals and drinks and whether or not they choose to participate in social activities. One person told us, “There are times where I don’t want to get involved in the activities taking place here so I can stay in my room.”

Staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff understood the need to gain consent from people for care and to encourage people to make decisions for themselves. Staff told us, “I have recently completed my training and I understand the importance of gaining consent from the people I support.”

Ensuring consent to care and treatment in line with law and guidance 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 Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. People had capacity to make day-to-day decisions. We found staff practice reflected the principles of the MCA. People were encouraged to make their own decisions, while still minimising risk. Staff understood their roles and responsibilities in relation to the MCA 2005 framework.