Croft House Rest Home

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• 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. For this key question we assessed 3 quality statements relating to delivering evidence based care and treatment, monitoring and improving outcomes, and consent to care. During the assessment we observed staff were asking for people’s consent, and their views and wishes were considered. However, not everyone had signed consent to care documentation and lacked support from an advocate when they struggled to make decisions. The registered manager acted during this assessment to ensure people received independent support. People told us they received effective care. Care provided was individualised and person centred. People’s needs were assessed, and care plans were developed to meet those needs. Staff worked closely with external health professionals and delivered care according to health professional’s instructions.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us they received care and support that met their individual needs. People told us they enjoyed the food, received plenty of drinks but there were no choices offered for their main meal. However, they could have an alternative if they did not like what was presented to them. One person told us, “All my needs are met. I am so glad I am in the home as I am so well looked after.” A second person commented, “We don’t get offered a choice at lunchtime, we’re just presented with a meal. I have in the past refused a meal and so they have found something else for me.”

Staff told us they worked well with each other and external services and were supported by management in meeting people’s needs. The registered manager told us community based health professionals visited regularly to assess people’s clinical needs.

The service worked with other health professionals and agencies. When appropriate, the advice of professionals was documented, and care plans developed to meet individual needs. One person told us, “The doctor is called for anyone who is ill.” A second person commented, “The doctor, the district nurse and a chiropodist visit residents.”

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us staff supported them effectively and promoted their wellbeing. One person told us, “All my needs are met. I am so glad I am in the home as I am so well looked after.” A second person said, “I feel fully supported at all times. They see to all my medical needs, and they are here to help me feel comfortable in the home.”

The registered manager worked well with other professionals to ensure people's health needs were met effectively and in a timely manner. Local health professionals spoke positively regarding working in partnership to meet people’s needs. One staff member told us staff were quick to contact GP when someone is unwell. One staff member commented, “We are good at noticing when people are unwell because we know them.”

There were daily handover meetings between staff to discuss people’s care needs and review if they needed further clinical, physical or emotional support.

People said they were asked to consent before care was agreed and staff supporting them offered choices when supporting them. Comments included, “I can make my own choices. If they come in my room to get me up, but I want to stay in bed they will let me stay in longer,” and, “Living here is just like being in my own home. I can make all my own decisions. If I decide to go out, I just tell the carers I am going to the shops and they let me go.”

During this assessment we observed staff were asking for people’s consent. The registered manager told us they had systems in place to ensure any restrictions in place were lawful and monitored.

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 MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). DoLS application had been made and legal authorisations were in place where required. Deprivation of Liberty Safeguards (DoLS) authorisations and assessments were in place to support decision making and any restrictions to people’s liberty. Some people’s consent was obtained for their care and support needs, and where appropriate people’s family or advocates were consulted on decisions. However, we noted some people’s consent had not been recorded and they did not have relatives or an advocate to help make informed decisions with or for them, when they had difficulty understanding relevant information. We made a recommendation to the registered manager that they helped people gain advocacy support, which was completed while we were on site.