Old School 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

At the last inspection, the provider was in breach of regulation 11 (Need for consent) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider did not routinely follow the code of practice of the Mental Capacity Act 2005. During this assessment we found improvements had been made. People’s needs were assessed and kept under review to make sure they received the right support and care. Staff worked well with other agencies to meet people’s healthcare needs.

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 received effective care because their needs were assessed and kept under regular review.

The registered manager told us in their Provider Information Return (PIR) they provided a person-centred approach to people’s care. They said the new computerised care planning system they used made it easier to monitor and identify changes to people’s care and to ascertain the support they currently required.

People’s needs were assessed before they moved in to the service and continued to be reviewed once they moved in. Assessments took into account health, care, well-being, and communication needs. A range of assessment tools was used to ascertain different needs and how to meet these. For example, risks associated with moving and handling and the likelihood of developing pressure damage. Information on the care planning system showed people’s assessments were regularly reviewed.

People’s nutrition and hydration needs were met in line with current guidance.

Processes were in place to screen people for the risk of malnutrition and other risks, and to refer people to specialist services if needed.

Staff training helped to ensure care workers kept up to date with legislation around good practice, such as moving and handling and skin integrity.

Staff had access to the information they needed to appropriately assess, plan and deliver people’s care. For example, assessments carried out by the local authority and hospital discharge plans.

A relative commented “The home have a good relationship with the local surgery and GPs and will fight our corner if something is needed.”

The registered manager told us they worked well with other agencies, such as the GP surgery, district nurses and pharmacy.

There was positive feedback from a healthcare and a social care professional about how the home worked.

Staff told us there was a focus on identifying risks to people’s health and well-being and on how to support people to prevent deterioration. One member of staff commented “All of the residents have care plans which we read, and if the needs of the resident have changed we will inform the manager and the kitchen staff will update the diet plan for the service user. If residents have falls, we will call for medical help if needed and then inform the manager and family. If the falls happen more often, the manager will change the care plan and put into place a sensor mat or a crash mat if needed…the care plan is updated so that we can have low risk.”

There were well-maintained records of when people had received visits from healthcare professionals, such as the GP, chiropodist and district nurse, and the outcomes of these. The records also showed staff had contacted other agencies for advice and to pass on concerns whenever these arose.

People were supported to keep healthy and well. One relative told us “(Family member) has done really well since they’ve been in there.” Another relative commented “(Family member) has had a few bouts of ill health in the time they’ve been there, but they have been on top of it.” A further relative told us “(Family member) did have a fall…but they immediately called the GP and myself when they realised they were in pain….the home handled the resulting hospital transfer well and again, after the operation…they went out of their way to aid their recovery.”

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.

People’s wishes were recorded in their care plans about how they wanted to be supported. Appropriate persons were consulted where people could not make their own decisions. A relative commented “I have been involved in 2 best interest meetings…there has also been an intervention meeting where (family member) was allowed to put forward their views.” Another relative said “There is a ‘do not resuscitate’ in place and they also know that we have Lasting Power of Attorney. All that is on record.”

People’s mental capacity was noted on their care records. A record was kept of who held Power of Attorney and what for, where people lacked capacity. Best interest decisions were recorded at the service and appropriate persons were involved in making these decisions. Discussion took place with the registered manager regarding good practice in ensuring people’s resuscitation wishes were reviewed when they moved between different services, for example, from being in hospital.

Managers told us they applied to the local authority to deprive people of their liberty, where this was necessary. They showed us a tracker form to indicate what stage these applications were at.