Angel Mount 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

People’s needs were assessed prior to their admission to the service. These assessments were used to formulate person centred plans. Monitoring tools were in place and people’s weights were monitored. People had access to a range of healthcare professionals and people’s consent was sought. However, relatives raised concerns about the staffs ability to recognise when a person had deteriorated but felt confident in the nursing staff abilities.

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.

Relative’s felt people’s needs were appropriately assessed prior to their admission to the service. One relative praised the assessment process. They said, “Before admission, we as a family visited the home, spent all afternoon here, we didn’t have an appointment but they were very accommodating. An assessment was carried out and they could meet [person using the service] needs.” Another relative felt the assessment process was thorough. They said, “There was a full assessment with the social worker, nurse and senior carer which I attended. They asked lots of questions about likes and dislikes.”

Staff told us they had seen people’s care records and had time to read them. Staff were familiar with people’s preferences and advised they were informed of people’s changes in needs through daily handovers. The registered manager explained the assessment process and how families were involved in the care planning process. The registered manager said, “We also involve families in care plan reviews, we look at every section.”

People’s needs were assessed prior to their admission to the service and these assessments were used to formulate person-centred plans. Initial assessments were very detailed and included a person’s medical information, life history and how they wanted to be cared for. Care plans were tailored to people’s individual needs and we saw evidence that the person, relative and staff had been involved in this process.

People and their relatives spoke positively about the food on offer and the support they received. One relative said, “There is a varied menu and they keep a note of [person using the service] weight as it had gone down at the last home. If [person using the service] is struggling with eating, there is someone on hand to support.” Relatives felt people were being weighed regularly and referrals would be made as and when appropriate.

Staff felt there was enough time to spend with people at mealtimes and told us people were offered a choice. One staff member said, “If meal is ready we invite them in, if willing, we will get them (person) to the dining room. It’s their choice where they want to sit.” The chef was aware of who was on a specialised diet and told us people had a choice of what they would like to eat. If a person didn’t like what was on the menu, an alternative would be offered.

Monitoring tools were in place including skin care and nutritional risk assessments to ensure people were receiving the appropriate level of care, tailored to their needs. Diets were monitored closely through documentation of food and fluids, monitoring of weight and referrals to dieticians as appropriate. There was a varied menu which included pictures of the food on offer and fresh fruit, biscuits and drinks were available to people throughout the day.

People and their relatives told us they had access to various healthcare professionals. One relative said, “Any concerns raised are acted on and referrals to the GP are made in a timely manner.”

Staff told us they had handovers twice a day which they found useful for finding out information about people. Staff felt they worked well as a team. One said, “Staff teams work well together, we have a good team.”

Partners said any referrals would be made to their services in a timely manner.

Handover information was very detailed and included important information about people as well as the staff allocation for the day. We saw evidence of referrals being made to various healthcare professionals including the dietician and speech and language therapy team which was evidenced in people’s care plans.

Feedback in this area was mixed and not all relatives felt staff would notice signs of deterioration. One relative said, “I don’t have a great deal of confidence in the general staff ability to recognise issues. If I have expressed concern, the nurse always reassures me.” Other relatives praised the staff for encouraging people to eat and drink well. One relative said, “They found out [person using the service] likes fresh fruit so there is always plenty in their room. They make sure they have plenty of fluids too.”

Staff told us they would know what to do should someone become unwell. One staff member said, “I would report any concerns to the nurse. I know people well.” Another staff member spoke about how they incorporated exercises into people’s daily lives. They said, “We do Zumba and chair exercises, some residents like dancing, they really enjoy this.”

Records relating to people’s specific health conditions were detailed and described what steps a staff member should take should a person’s health condition deteriorate. Care plans held records of referrals and detailed plans tailored to that person. However, we did find some incidents that had occurred which staff had not recorded correctly. The registered manager spoke to staff during the inspection process about the importance of robust documentation.

Relatives felt people were encouraged to eat and drink well and assistance would be given by staff if required. Relatives told us they were involved in reviews of care plans. One relative said, “I have seen the care plan, we had a review a few months ago and went through all the care plans.”

Staff told us they used activities and distraction techniques to improve people’s quality of life. One staff member said, “We do exercise, chair exercise, foot massage, dancing and go into the garden.” Staff told us they had training on supporting people when they experienced distressed reactions.

Tools for monitoring outcomes were robust. Audits of accidents and incidents were detailed and included an analysis of events which had occurred. Behaviour charts were reviewed by the registered manager and included a section on whether distraction techniques had worked and how to help prevent future incidents occurring. Staff supported people at mealtimes to ensure they maintained a healthy diet.

Relatives told us they had signed consent forms for people on their admission to the service. Relatives felt choices were offered and respected. One relative said, “Nobody is being forced to do anything. It is a nice atmosphere.” Relatives felt included in the DoLS process.

Staff spoke about the importance of gaining consent before any care interventions. They said, “We always ask for consent, it is part of their dignity and privacy. Everything we do, we should ask for consent.” Staff talked us through the process of what they would do should a person refuse care and treatment. They said, “(If someone refuses care) approach another time. If (person) refuse again we wait or ask a different staff member to try.”

DoLS paperwork was up to date and the relevant conditions were being met. Capacity assessments and best interest decisions were in place for a range of tasks which evidenced capacity was time and decision specific. Consent forms were in place and signed by either the person or their relative.