Herondale

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 and monitored, and they were involved in the assessment process. Care plans were in place to ensure their care and support was person centred and effective. People were able to consent to their care and support as much as possible. Where people lacked the capacity to make decisions, these were made in their best interests, in line with legislation and best practice.

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.

People’s needs had been assessed and they were involved in their plan of care. A person said, “They [staff] help me decide on things, when I am not sure.” However, all the family members we spoke with told us they were not involved in the reviews of their relatives’ care, with most saying they did not know what information was in their relative’s care plans. A family member said, “I think it would be helpful to both of us to be involved in any reviews or updates of [person’s name] care. I don’t think I have ever been sent anything.”

Staff said they could easily access people’s care plans and what their needs and choices were. They were involved in reviews of people’s care and changing needs. A staff member said, “We are such a small team that we pass over information when we need to.” Staff recorded people’s day to day lives which were mainly about tasks completed, such as, “watched TV, eaten well, complied with medicines, assisted with personal care”. Some people’s daily notes were hard to read as the writing was illegible.

The process for monitoring and managing information about people’s needs was not robust. The information contained in the assessment of need was not always updated with the correct details or organised effectively to understand people’s needs. For one person, information about their risk of choking was not detailed enough to know how staff and external professionals could support them. For another person, their fire risk assessment was not up to date with the change in their mobility needs which may place them at risk of harm. There had a system in place to assess people’s needs before going to live at Herondale. This was to make sure the service could meet their needs but also consider the needs and welfare of those already living at the service.

The provider planned and managed people’s care and support with them and they were supported to go about their daily lives. Staff supported people to eat a healthy and balanced diet. A staff member said, “We try all the time to suggest different meals, but often people just want their favourites every week.” People were involved in going shopping with staff, preparing drinks and snacks. Main meals were cooked by staff. Menu choices were discussed and agreed with people, and they could eat as a group or individually.

Staff knew most people who used the service very well. Staff could tell us what food and drink people liked and how they preferred their meals. They were also aware of how one person needed their food prepared as they were at risk of choking. The registered manager offered people the opportunity to spend time in their office, with crafts available or just a comfortable space to be and quiet time. A timetable was placed on the office door which people could access.

The process of checking how people’s information was recorded in their care plans was not robust in order to ensure good outcomes for them. For example, not having the same information in all sections of the care plan related to food preparation and texture for someone at risk of choking. People were supported to manage their own care and were supported where and when needed.

People received personal and health care support which was coordinated to meet their needs.

Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support alongside other professionals. Staff supported people to attend hospital and other appointments as needed.

Professionals were positive about the way the service worked with them. One professional told us, “The staff liaise with me, and we work well together.”

Plans for transition, referral, discharge from hospital and admission to the service considered people’s needs, circumstances, and ongoing care arrangements. The registered manager communicated with external professionals and services for a coordinated approach and to maintain continuity of care.

People were supported to manage their health and wellbeing so they could maximise their independence choice and control. People’s health needs were discussed with them and their family members to ensure they lived healthy lives.

Staff were aware of people’s needs and recognised when something was not right. They told us they would always raise concerns with the manager as quickly as possible. The staff had recognised a person had recurring urinary tract infections. They researched remedies for this, and the person agreed to try some ‘Jelly drops’ specifically to aid hydration. Staff reported that having these everyday had kept the person well.

Referrals to health care professionals were made in a timely way and results of any intervention were recorded. A professional said, “They support [person’s name] with their personal hygiene, meals and making sure they have their medicines They are supported with hospital appointments.”

Most people were independent to come and go and spend time as they wanted. Staff provided consistent support and knew people well. We observed people were comfortable with staff and staff responded in a timely way to requests for cigarettes, drinks and money to go out, so people had what they needed when they needed it.

Staff told us about one person who could not go out as they were experiencing mobility issues. Staff had not looked at alternatives for the person such as the use of a wheelchair in order to take them out. We observed a person asking to access the community and whilst staff explained why this couldn’t happen, they did not provide opportunities in its place or seek ways to facilitate this request. Therefore, outcomes were not being improved for this person.

There were processes in place to monitor people’s activity and daily lives in order for them to keep well, focussed and safe. This included routines around having their medicines on time, smoking and going into the community. The daily notes recorded people’s day to day lives which were task focussed and did not always record how people thought and felt about the outcome to their day. The provider was unable to show us that continuous improvements were being made to people’s care and treatment. We requested examples of good outcomes for people over the past year and we received one in response.

People were able to consent to their care, treatment and support. People were respected and they had choice and control in their lives. One person said, “I am going to choose what to do today, wear my hat, and wait for [name of family member] to come.” We observed staff engaging with people who had different ways of communicating, offering them options and enabling them to make their own choices and decisions. For one person whose needs had changed, it was recorded that staff should work flexibly to ensure their shopping needs were met while they were unable to walk to the shops. Where people lacked capacity to make decisions or decisions were taken in their best interests, people had representatives such as Court of Protection and Lasting Power of Attorney [LPA] involved. A family member said, “The staff let me know how [person’s name] is, and we chat when I pick them up. I don’t see their care plan, but they let me know any changes.”

Staff received training in the Mental Capacity Act 2005 [MCA] which helped ensure they understood the principles of the act and put the training into practice. Staff knew people’s needs and backgrounds very well. This enabled them to support people in a way which respected their rights and best interests. Staff were patient at explaining the reasons behind decisions made on people’s behalf. Staff were aware of people’s rights to refuse care and treatment and said they would respect the persons wishes. Staff were able to explain how people could be restricted in their freedom to leave the service under a Deprivation of Liberty Safeguard [DoLS].

There were effective systems to ensure that people’s capacity was assessed and recorded. We saw people signed to this consent. MCA assessments provided staff with the necessary information as to decisions made and action to take. DoLS had been obtained correctly and were monitored and reviewed to ensure they were effective.