Helen Ley 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

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. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People and their relatives had a meeting with therapy staff within 24 hours of moving into the home. Staff assessed people during the meeting so they could understand the person’s condition and formulate a treatment plan based on what was important to them and what their goals were. Psychologists, occupational therapists and physiotherapists, along with the nursing and care team worked together as a multidisciplinary team so the emotional, functional and practical needs of the person could be understood. Assessments were regularly reviewed to ensure they continued to meet people’s needs, and any changes were identified and responded to. A member of staff explained, “It is really important to include people and their relatives in the assessment of their care needs. We do this by goal setting with the resident because their treatment plan comes from that. We hold regular family meetings with the resident to give them details of progress that has been made and discuss future goals.” People confirmed their involvement in reviews of their care. One person told us, “I have regular meetings to update my care, my care plan is discussed with me.” A relative confirmed, “[Name] has a care plan, and it does get updated. We have had 2 reviews so far and there were 5 staff there.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. Staff worked to plan and deliver high quality care based on best practice and evidence-based research. Staff explained how they made sure people were receiving evidence-based treatment using a baseline measure of the person’s psychological, social, functional and practical state. The baseline was used to develop a care plan in line with the person's goals and planned outcomes. Progress was regularly reviewed using a multidisciplinary approach to measuring achievement towards each goal. Where progress was not as anticipated, alternative treatments or therapies were explored. A member of staff explained, “We are encouraged to do research around treatments to ensure they are evidence based. If treatment is not effective, we would take a new approach by researching alternative treatment techniques and discussing and reviewing their implementation with the team.” Assessments of people’s nutritional risks were supported by evidence-based guidance such as the Malnutrition Universal Screening Tool (MUST) which is a nationally recognised and validated screening tool for adults to establish nutritional risk. Staff made sure people had enough to eat and drink, including those with specialist nutrition and hydration needs. They used special feeding and hydration techniques when necessary. Specialist support from staff such as dietitians and speech and language therapists was available for people who needed it.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff told us nurses, care staff, the therapy team, and other healthcare professionals worked together as a team to benefit people and supported each other to provide good care. For example, a member of staff said, “If a resident has dysphagia (difficulty swallowing) we would work with the speech and language team to improve the way we are able to communicate with them.” There were established links with the GP, neuropsychologist and other specialist consultants who visited the home regularly. This meant healthcare professionals could build up a knowledge of people and ensure continuity of care. Healthcare professionals told us information was available when they needed it and any requests to carry out monitoring checks were complied with. One healthcare professional commented, “Helen Ley always ensure that the relevant members of the team are available on the day of the clinic. The clinic is hence always multidisciplinary. I have all the necessary information readily available, and this renders the clinic very effective.” Staff told us they were kept informed about changes in people’s needs through staff and handover meetings, and working together. One relative told us, “The staff work very well together, there is never any conflict.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Therapy staff worked with people to improve their functional abilities for example, showering, walking, and transferring from their wheelchair to their bed or another piece of equipment. Therapists involved care staff in these sessions to ensure they were confident about the techniques being used so they could be continued as part of people’s day-to-day care. One therapist explained, “Functional therapy promotes independence, so it is important the care staff continue to maintain this level of independence for residents they are working with.” People were supported to attend routine appointments with the dentist and optician to maintain their health and wellbeing.

The provider monitored all people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and fully met clinical expectations and the expectations of people themselves. People told us how the holistic and therapeutic approach to monitoring their care helped them achieve positive outcomes. One person told us, “I have a therapy timetable, and I do something every day. It definitely helps me. When I came in, I was in a wheelchair and now I’m not.” A relative commented, “The progress [Name] has made is absolutely brilliant. There is a sheet with their therapies each day. They are very enthusiastic about them because they want to get better.” Staff held regular and effective multidisciplinary meetings to discuss people and improve their care. Staff told us they used these meetings to review the progress people had made towards meeting their goals and to formulate different approaches if progress was not being made. A member of the therapy team told us, “When people arrive, they are assessed using non standardised and standardised cognition and functionality tests. These tests are repeated every 3 months or less. If there is no improvement in cognition or functionality this would be discussed with the neurological rehabilitation consultant and other members of the multidisciplinary team so the care plan can be reformulated to improve the outcome.” Another therapist explained monitoring outcomes included measuring, “A reduction in care need, improvement in independence and reduction in the amount of equipment needed. These outcomes can be recorded in patient notes, on recording forms, or through videos to visually demonstrate improvement.” Healthcare professionals told us, “The staff appear to work together as a team and effectively monitor patients and achieve positive outcomes” and “Helen Ley is very professional and highly efficient to monitor any outcomes. I rely heavily on their input to decide the next therapeutic plans.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood the principles of the Mental Capacity Act 2005 and supported people to make informed decisions about their care and treatment. Therapy staff were skilled in how they obtained people’s consent, involving them in decisions even where language, disability or other impairments made this difficult. Therapy staff told us they spent time with people to get to know them and to understand how they communicated. They understood this was not through language alone and that some people communicated, for example, through eye movements, nods, and gestures. Where people declined support, staff respected that decision but discussed it with people to ensure their immediate needs were met. Where people had made decisions with risk, the provider worked with people to mitigate those risks. Staff understood how and when to formally assess whether people had the capacity to make decisions about their care and treatment. When people could not give consent, staff made decisions in their best interest, considering people’s wishes, culture and traditions. A member of staff told us, “It is always really useful to review capacity assessments to help you understand what’s important to that person to help you decide what’s in their best interest.”