Edward 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

Peoples needs and rights were not always supported. Peoples care and treatment was affected due to their health, care, well-being, and communication needs not always being assessed with them. Peoples care plans and assessments were not always kept up to date and completed in a timely manner. However, Staff were aware of people’s preferences and respected these. People were not always aware of their rights around care and treatment.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not able to explain how they were involved in assessing their care and support needs. People had not been given the opportunity to have a holistic review of their physical, mental and support needs. This meant people were at risk of not receiving the best possible outcomes.

Staff told us they do not assess people’s needs; this is the role of the management team. Where people’s needs have changed, the care planning documents are updated, and are shared with staff during handover. Management told us they assess everyone’s care and support needs with people and their relatives before they start living at Edward House. However, management were unable to explain their processes and systems to continue to monitor and review people’s needs.

Care plans and assessments demonstrated people were not involved in assessing their care and support needs. Care plans and assessment were reviewed monthly. However, the reviews were ineffective, staff had not identified that care plans were not reflective of people’s needs and not always identified people’s needs had changed. For example, one person’s care plan had conflicting information on how many staff members they needed to support with their mobility since there had been a change in their mobility needs. This meant people could be at risk of receiving unsafe support and risk of harm. People who showed signs of distress or agitation had not had their needs assessed and staff were not provided with clear guidance on how to support people who showed signs of distress or agitation. For example, on 3 occasions we observed the same two people verbally abusing each other. On all 3 occasions staff were not able to respond to ensure a positive and safe outcome. People were weighed weekly, and this was reviewed by management. However, there was no information on what people’s individual weight range should be. Without this information management were not able to effectively review and identify if a change in weight was a risk or a concern.

Staff did not have good knowledge of tools that the service used, and how they impacted the care given. For example, one staff member could not explain who was on a modified diet to reduce the risk of choking. This placed people at risk of choking. People did not always have their assessed hydration support needs met. A staff member told us, “Due to staffing levels we cannot always support people with ensuring they have had enough fluids. They [people] have drinks in front of them, most of the people cannot help themselves they need us to support them or remind them to drink or we have to physical support them, but we don’t have time to do this. We had someone who we thought was having a stroke, however when he got to hospital, they found he was very dehydrated.”

People told us they had not been involved in decision making regarding their care and support.

People’s nutrition and hydration needs were not always supported in line with good practice guidance. We observed people had drinks, but staff did not always ensure people had enough to drink. For example, we observed one staff member left a drink for a person, not within their reach and they were unable to independently get the drink. We also observed a person who was cared for in bed and in their room without a drink for most of our on-site assessment, we were therefore not assured the person had enough to drink. Systems or processes were not in place to ensure people had enough fluid as assessed. Only, 41% of staff had completed nutrition and hydration. People who were at risk of weight loss had been supported by staff to source additional weight gaining supplements.

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.

The provider had implemented the use of MUST scoring records in people’s care plans. MUST is a 5-step screening tool to identify where people are malnourished or at risk of malnutrition. The forms were incomplete and did not contain guidance for staff. Scores were not accurately calculated. This meant people were not effectively identified as at risk of malnutrition so may not receive the appropriate care intervention to maintain their health. Reviews were documented as being completed but they had not identified or addressed this issue.

We observed that people did not always experience appropriate support to live healthier lives. During our assessment we observed a person, had not received timely medical care during our onsite assessment. A person who had been diagnosed with heart failure, was unwell and showing signs of possible respiratory concerns. Management and staff failed to ensure medical advice was obtained. An inspector had to prompt the management team to contact a medical professional to obtain medical advice. This meant people were at risk of not receiving timely medical support.

Staff and management felt they supported people living at Edward House to live healthier lives. Staff and management told us that they work with the primary integrated community service (PICS). This is an NHS community service to help people live healthier lives. One staff member told us, “We have a PIC'S team every Wednesday and they will support with health support. “Management told us they have an external company who come in and provide an exercise class and another company with emotional therapy. Staff told us they support people to live healthier lives. One staff member told us, “We do offer healthy options, we have fruit on the dessert trolly as an option. We do milkshakes as well and go round twice a week to support with vitamin intake.”

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.