Shandon 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

People told us that staff were supportive and met their needs well. We observed people being given regular choices, staff asking people’s consent before supporting them and activities undertaken which promoted healthier lifestyles. The care that staff provided was in line with best practices and encouraged good outcomes for people, however the documentation around this needed to be improved. This was especially pertinent around mental capacity assessments and best interest decisions. The registered managers had already identified this and were taking proactive steps to address the matter quickly. Staff worked well with each other and external professionals to provide good, effective care for people.

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.

People told us they felt their needs were being met, and these had been assessed before they were admitted to ensure they could be safely supported. One relative told us, “There is good communication from the staff who are all getting to know [person] and they appear to be settling in well.” Another added, ““We had a meeting on admission with the [registered] manager who was helpful and understanding”

Staff advised that they read care plans and updated daily records each day to ensure they are up to date with people’s needs. Daily records needed to be completed more thoroughly to ensure all aspects of a person’s day to day care and support including any incidents had been recorded accurately. This is something that the registered managers and staff were working on.

Processes were in place to assess people’s needs before they were admitted to Shandon House. If anyone has increasing needs, then management completed a review and made families aware that people may need to move to a home that can meet people’s higher needs. Care plans and risk assessments needed improving to provide clear information in relation to people's health conditions, for example diabetes, dementia to include mood, behaviours and any triggers for staff to look out for. Dietary needs were recorded, however for people with diabetes or specific dietary needs these were not always clearly recorded. Staff demonstrated a good knowledge of people’s needs but we highlighted the importance of this being explicitly documented.

People reported that staff were responsive to their needs and monitored them closely to assess when additional support was required. For example, one person told us about a recent health complaint which had occurred, and due to this staff had arranged for them to see the paramedic practitioner.

Staff knew people’s needs and how to deliver care in line with these. For example, staff knew how to support a person with a pressure sore and that they required a pressure cushion to try and reduce further pressure damage.

Processes allowed people’s needs to be assessed in line with best practice principles. However, the documentation of this needed improvement. For example, staff were working within the principles of the mental capacity act however best interest meetings and decisions had not been fully recorded. Tools such as the Waterlow, which are used to assess risks to people’s skin, had been used to plan care.

People told us that they liked staff and felt staff respected them and their needs. People and their relatives both commented on how it is like a family, and everyone works together. One person said, “We had a fire alarm [test] yesterday, staff worked together and were very good at getting us all out and safe, incredibly good, [staff member] directed us with real professionalism, they are excellent at their job.”

Staff told us they worked well together and felt supported by management. There was an electronic application used for handovers, but information was not always recorded in detail in people's care records. This was raised with the registered manager who were reviewing this.

Staff and registered managers worked well with other health professionals involved in people's care. Professionals who we spoke with expressed positive relationships and that staff spoke with them regarding appropriate matters to ensure good care for people.

Processes were in place to enable staff to have a clear line of communication with each other and external professionals. There was a regular visit from a paramedic practitioner where any concerns or queries about people’s health needs could be discussed. Health professionals spoke positively about the home and the care provided.

People felt they were supported to live healthier lives. People felt they were involved in care decisions and were listened to. One person told us, “Food is pretty good, I don’t turn my nose up at any of it, I am Diabetic so am careful with desserts, I can eat most of the main meals, we are given the choices the day before, I get appropriate snacks, plenty to drink and a jug of water in my room. Food is nutritious.”

Staff encouraged people to take action to live healthier lives. There were regular exercise classes offered as part of the activities schedule, which people told us they enjoyed participating in. Staff also supported people to go for walks and eat a diet which matched their dietary requirements. Staff knew each person’s ability and what they enjoyed engaging with to ensure people were best supported.

Processes were in place and utilised to promote healthy lifestyles for people. For example, we saw that people’s weight was regularly monitored and adjustments made to the menu to facilitate weight gain or loss where necessary. The home worked closely with external agencies to encourage people to take positive action to promote a healthy well-being.

People were regularly asked for feedback regarding their care. Resident and relative meetings took place and people’s feedback, and comments were regularly sought. This enabled any areas for improvement to be identified or where changes were required. For example, people had requested certain changed to the menu which had been implemented.

Staff worked closely with people who lived at Shandon House to ensure that their wishes and outcomes were known and worked towards. Regular handovers were undertaken electronically so staff could keep updated with any changes or developments in people’s care.

Some areas were clearly and thoroughly audited by the registered managers and staff, for example, there was good oversight over maintenance and training. However, other areas needed improved management oversight to identify areas for improvement. This was acknowledged by management, and they had taken active steps to work with the local authority to identify areas which needed to be developed and improved to promote better outcomes for people.

People told us they were involved in decisions about their care. People and their relatives expressed how they were given choices and asked for their consent throughout the day. Our observations also confirmed this. One person said, “I prefer to rest in my room, but [staff] always come and ask if I want to join in. I can do exercise, games and tried crochet. Staff are all respectful when they speak to me.”

Staff were aware of what consent was and had had training about the mental capacity act. More robust recording was needed in relation to best interest decisions and mental capacity assessments. Discussions had taken place with people, relatives and health professionals, but this was not always clearly recorded. Staff and registered manager knowledge of which people were under Deprivation of Liberty Safeguards (DoLS) was mixed and needed improvement to ensure this became more robust across the workforce.

Deprivation of Liberty Safeguards (DoLS) had been requested appropriately where needed. Processes were in place for referrals to be made as necessary and the registered manager was in discussion with the DoLS team regarding a person who had changing needs which increased their risk of going out alone. Care plans and risk assessments needed reviewing to ensure all information about consent, mental capacity and best interest decisions was available to all staff. The registered managers were taking action to address this.