HF Trust Gaston House

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 ratings assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s 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 did not always make sure people’s care and treatment was effective because they did not always check and review people’s health, care and wellbeing needs with them. People’s support plans were developed from an assessment of their needs. However, the process to review support plans had failed to identify some changes in need were not reflected throughout the plan. The registered manager recognised this was an area for improvement and told us they were introducing reviews of support plans as part of the monthly meetings between people and their keyworkers. Keyworkers are named staff who work closely with people and their families to ensure people’s needs are met. The registered manager explained this was not yet embedded throughout the home due to recent changes within the staff team.

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. A member of the provider’s positive behaviour support team explained how they made sure people were receiving evidence-based treatment using data and functional assessments. The gathered information was used to develop a support plan which was regularly reviewed to measure achievement in supporting the person’s emotional and mental wellbeing. They explained, “We see the PBS (positive behaviour support) plan being implemented as a halfway mark as we support a long-term approach. After 3 or 6 months we will review the plan, looking at the data and science around the behaviours.” Staff made sure people had enough to eat and drink, including those who required a modified diet due to their risks around eating and drinking. Staff encouraged people who needed to manage their weight to make healthy food choices. Specialist support from other healthcare professionals such as dietitians and speech and language therapists was available for people who needed it. Advice from specialists was incorporated into people’s care plans. Information about modified diets was available to staff when preparing people’s meals.

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. The provider had formed established links with the GP, psychiatrist and other specialist healthcare professionals. Staff told us how they shared information about people through handovers and a communication book to ensure any changes in need were known and escalated when required. For example, staff had identified 1 person needed more support with some aspects of their communication. The person had been referred to the speech and language team for specialist guidance. A visiting healthcare professional told us, “They always know I am coming, and everyone is aware and ready for my arrival. I have a good chat if I need to with the staff and am usually okay to get information from them if I need to." Another healthcare professional told us, “We have a great working relationship and there is mutual professional respect allowing for care plans to be implemented without delay.”

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. People were supported to attend regular checks and receive ongoing care from healthcare professionals such as dentists, opticians and chiropodists. People had annual health reviews with their GP to help them stay well and identify any emerging problems so they could be responded to quickly.

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. Where a need was identified, staff monitored aspects of people’s care to identify any patterns or trends and to support information sharing with other healthcare professionals. For example, one person was demonstrating heightened anxiety. Staff were recording incidents to enable the provider’s positive behaviour support team to develop a support plan. The plan would provide staff with a consistent and effective approach to de-escalate and respond to incidents to keep the person and others in the home safe and promote positive outcomes. Recorded information would also help external healthcare professionals assess the effectiveness of medication and other healthcare interventions. A healthcare professional told us, “Any request for monitoring/checks are always at hand, be it from weights to stool charts, this information is readily available if requested.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. During our assessment we heard staff asking for people’s consent before providing care. Staff understood their responsibility to involve people in making choices about their care and communication plans informed staff how people demonstrated they were happy and accepting of the support being offered. The registered manager understood how and when to formally assess whether people had the capacity to make decisions about their care and treatment. Capacity assessments were detailed and contained information about how people had been supported to understand the decision to be made. This included visual aids, videos and easy read formats. A healthcare professional told us, “We have quickly arranged best interest meetings with next of kin and hospital teams to speedily come to solutions for more difficult cases.”