Patron 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

We assessed all the quality statements in the effective key question. We found practice had improved and rated this key question as good. The provider had made improvements to food and the dining experience and people’s nutrition and hydration needs were being met in line with current guidance. People had care plans which were personalised and reflected their needs. This helped staff to deliver appropriate care and support. People’s care and needs were monitored using recognised tools and regular reviews. Visiting professionals told us the provider worked in partnership with them and followed their recommendations. Staff promoted health and wellbeing by providing healthy meal choices and encouraging people with activity and exercise. Staff assessed people’s capacity to make decisions and ensured these were in the individual’s best interests and made with them or relatives wherever possible. Staff listened to people and gave them choices and time to respond. Leaders were involved in new approaches and developments to improve people’s experience.

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 had care plans which were personalised and reflected their needs. Most people we spoke with were unsure if they were involved in reviewing care plans, but some relatives told us they had spoken with staff about this to ensure information remained accurate and up to date. One relative did not recall being involved in developing a care plan for their family member but said, “I think I would like one really. Next time I go I will enquire about a review of her care plan so they will have a better picture of what she likes and dislikes.” People’s communication needs were assessed and documented in care records to help staff effectively provide care and support.

Staff knew people well and told us about them without referring to documentation. They knew information was recorded to help them deliver personalised care which met people’s current needs. This included details about people’s physical and mental health, communication needs, background information and personal information about the individual. This supported staff to deliver the right care and support. Most staff told us records and care plans were in place before people came to the service and information was shared at handovers and via group chats. However, one member of staff said they wanted more information about new admissions. They told us, “We should get more information, we need to seek information out ourselves.”

The provider was aware of current best practice and legislation when planning and delivering people’s care. This was monitored to ensure consistency. A range of evidence based tools supported the assessment of people’s needs.

People received support to eat and drink enough to maintain a balanced diet. They gave us mixed feedback about the choices they had regarding food. Comments included, “The food is good but there’s no choice for dinner. Tea is a sandwich, and I can have snacks. I can have tea and coffee whenever I want” and “I ask for cups of tea and they bring them to me. If the soup was strained, I’d have it, but they don’t strain it. I don’t like the food here.” A relative added, “[Name] is not a big eater, and I was concerned about their weight so I mentioned it, and they got the GP involved who prescribed supplements which [Name] can drink.” People told us they were either supported to take part in activities or chose not to participate in them. We saw evidence of recent events such as D-day celebrations, a garden party and entertainers visiting the service. Relatives were less sure about what activities their family members engaged in. Comments included, “I feel there should be more for her to do and more encouragement for her to get involved in different activities” and “She won’t do activities even though they try. She likes to stay in her room.”

The provider had aimed to improve food and the dining experience at Patron House and people’s nutrition and hydration needs were met in line with current guidance. Staff told us they monitored what people ate and drank and completed regular checks of people’s weight. A few people had their main meals prepared by staff on site, but most meals were prepared at another service run by the provider. We received mixed feedback from staff about the food choices available to people. Most staff felt the catering arrangements did not provide people with sufficient choice. A staff member said, “It can be better, was alright today. [Name] and [Name] get to choose. Not sure about the others.” Another staff member said, “They don’t choose food. We don’t have any option. We try other things in the kitchen. Make beans on toast or an omelette.” A training manager helped to ensure appropriate training and guidance was in place and staff told us they received sufficient training and support. We were told regular meetings and opportunities arising from the provider’s partnership work supported staff to learn about new and innovative approaches in the care sector. Leaders were involved in new approaches and developments to improve people’s experience.

Care plans contained information about people’s health and care needs. During the assessment we found care was not always delivered in line with good practice standards, for example in areas such as infection control and medicines management. The management team acknowledged the shortfalls identified and informed us of the actions they planned to take to improve.

People told us their health needs were met and they could access health professionals when necessary. Comments included, “I would think appointments would be arranged”, “I can see a doctor when the occasion needs it” and “I fell, and the doctor came and gave me paracetamol.” A relative added, “They have a GP who goes to the home and [Name] has dentures which they must help her clean. An optician has been to see her, and she has got 2 new pairs of glasses.”

Staff told us they worked effectively with other professionals. One staff member explained information and changes were, “Shared during handover. They talk about the problem and what is to be done in the future.” Staff explained there were regular visits from GP, district nurses and other health professionals.

Visiting professionals told us the provider worked in partnership and followed their recommendations.

Processes were in place so that staff could make referrals promptly to health professionals and specialists. Information was shared appropriately to clearly communicate people’s needs and ensure continuity of care. Changes to people’s needs were discussed in handovers and team meetings. We were not aware of any planned transitions, referrals or discharges at the time of our assessment.

People were encouraged to make health and wellbeing decisions, for example about their own pain relief or their daily routines. This showed people were empowered to make choices and have more independence about their health and wellbeing.

The acting manager and staff team demonstrated that they knew people well. They worked in partnership with health professionals such as the GP, district nurses, occupational therapists and the dementia wellbeing service. The GP carried out weekly visits to the service. This helped identify risks to people’s health and wellbeing early and supported staff to follow guidance to prevent deterioration. Staff promoted health and wellbeing by providing healthy meal choices and encouraging people with activity and exercise.

Records showed the provider monitored and promoted healthier living. People or their relatives were involved in regularly reviewing their health and wellbeing needs where appropriate and necessary.

People were not sure about how their needs or care were monitored, but they were generally satisfied with the support they received. Some relatives had attended review meetings with staff, but others said they were less involved. People had experienced positive outcomes such as weight gain, more stable mental state and more social contact.

Leaders were proactively involved in a range of projects and initiatives to help improve people’s care and outcomes. Staff were encouraged to understand and follow best practice when caring for people. Staff told us they felt people’s care plans and risk assessments were sufficiently detailed, however we received mixed feedback from staff about having enough time to read people’s care plans.

People’s care and treatment was monitored using recognised tools and informal reviews. This meant changes and improvements could be made promptly to improve outcomes.

We saw staff respecting people’s rights when delivering care. Consent was obtained and people’s views and wishes were met as far as possible. People’s capacity was considered, and decisions made in people’s best interests met the requirements of the Mental Capacity Act 2005 (MCA). People were encouraged to make choices during our visit and staff listened to them and gave people time to respond. One person said, “The staff know my preferences. You can get up whenever you want to. I do what I like.”

Managers told us people’s mental capacity was assessed and reviewed and records confirmed this. Staff completed training about the MCA and we saw them obtaining people’s consent. However, not all staff were able to explain the principles of the MCA or Deprivation of Liberty Safeguards. We highlighted this to the management team, who said they would review staff training.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff assessed people’s capacity to make decisions and ensured decisions were in the individual’s best interests. Assessments were discussed with other parties and outcomes recorded. If needed, there were appropriate legal authorizations to restrict people for their own safety. In care homes these are called Deprivation of Liberty Safeguards (DoLS).