The Hermitage

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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

We assessed 2 quality statements from this key question. We have combined the scores for this area with scores based on the rating from the previous inspection, which was good. Staff supported people to see healthcare professionals where there were changes to their healthcare needs, and staff had a good relationship with healthcare professionals. People told us they were supported in a way which met their individual needs and preferences and felt staff knew them well. However, people’s care records lacked detail and policies and guidance required more regular reviews.

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 thought staff knew them well, including what their preferences were. One person said staff respected their decision to stay in their room. A person’s relative commented, “Because she is seeing the same people all the time they have got to know how to look after her and she knows them and trusts them.” People told us their nutritional and hydration needs were met. One person said, “The girls are always coming in to check you have a drink. At night they will bring me 2 beakers of water as they know I get thirsty.”

Staff told us they knew people’s individual needs and wishes, including their dietary needs. Both the manager and deputy manager told us how they followed advice from healthcare professionals in relation to people’s care needs. For example, they worked closely with district nurses to plan people’s care.

Whilst staff worked closely with healthcare professionals, care records were not detailed and reviews of people’s care did not always take place. We also found care records contained conflicting information. Policies and guidance had not been regularly reviewed.

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.

All of the people we spoke with told us they were supported to see healthcare professionals. One person said, “I have fluid on my legs and they swell up when I walk so I need to keep them up and they make sure I do. I haven’t really needed the Doctor but [Staff member’s name] gives him a report now and again.” A second person told us, “They will always help you to see the Doctor or other people if you need to. They don’t leave you to be ill.” We received positive feedback about the food and people told us their preferences were catered for.

Staff told us they would contact a person’s GP or specialist healthcare professional if there were concerns about a person’s health. One staff member told us how one person is seen regularly by the district nurse team and added they can phone the district nurses at any time for advice. The management team reported having a good relationship with healthcare professionals and found them supportive.

A review of care records showed there was a lack of supporting people to make healthier choices. Admission assessments did not capture enough detail about people’s care needs and 1 was found to contain conflicting information about a person’s mobility needs, making it confusing to ascertain what their needs were in relation to this.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.