Wilford View Care Home

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 inspection we rated this key question as good. At this inspection the rating has improved to outstanding. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 96 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The management team ensured they fully involved people and their relatives in care planning and reviews. The majority of people and relatives we spoke with gave positive feedback regarding involving them as partners in their care, although some people and relatives had limited recollection of involvement. One person said, “They talk with me and make the changes I ask for. I’ll ask for something to be done differently too.” Another person said, “We go through it every so often. I’ll speak up if I need any changes.”

The management team always 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. They worked to develop evidence-based good practice and standards. People were supported to maintain a good nutritional and fluid intake, to support with ensuring their health and wellbeing. Care plans and risk assessments in place for people’s identified health needs always followed best practice guidance. Staff we spoke with understood the importance of ensuring care delivery met these standards. Where people were being monitored for their weight, we saw regular checks of this were recorded. If this weight fell out of range, prompt referrals to health teams were made. One person said, “We get drinks with meals, and I’ve got my jug of water. The trolley comes round a couple of times a day and the night staff make us a drink. I’ve only got to ask for anything extra.” One relative told us, “They’re always bringing my family member drinks and they’ve always got a fresh jug of water.” We observed during our inspection that people were being offered regular drinks by staff, with this being consistently recorded in their daily records. If daily records for people who were being encouraged to increase their fluid intake showed this had not been achieved, there were flags in place on the electronic system to alert staff to this. Where people lived with a risk of falls, we saw robust risk assessments in place. These detailed multi factorial risks, considering the impact of medicines, hydration levels, infection risks and a person’s gait and balance. Staff we spoke with understood the importance of encouraging mobility, whilst considering these risks.

The management team always worked well across teams and services to support people. They compiled thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once. Care plans were truly person centred and focussed on people’s clinical needs, communication requirements, wishes and aspirations. We saw these had been clearly communicated so a consistent approach was maintained between services. The service worked in effective partnership with external partners, to ensure people had a positive admission to their new home. If people required assessment from an external health or social care team, we saw the service had made prompt referrals and followed up on the prescribed actions. One relative told us, “They’ve been very quick to get the doctor in or call an ambulance when my family member was unwell with their chest. They also get a regular chiropodist session, and the hairdresser here keeps them well trimmed.” People were supported to access holistic care, with support from external teams. A visiting health professional gave feedback about how the service worked effectively with their team. They told us, “Staffing has improved and reduced emergencies. The service has good care coordinators, who understand people’s clinical needs.”

The management team always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People were enabled to confidently access emergency health care ensuring they received prompt care and treatment. The local GP practice carried out regular ‘ward rounds’ to ensure people had regular review of their medicines, or emerging clinical concerns. The service worked effectively in partnership with health and social care teams. Ensuring people had access to any support or equipment they required. People were supported to access external appointments, providing full ‘wrap around’ support. People had oral care plans in place, detailing their preferences, and any support needs. Daily records showed people were supported to maintain independence with cleaning their teeth or dentures. A display board showed the importance of good oral health. People had access to dental services. A dentist visited the service to carry out regular review for people who may be unable to attend external visits. One person said, “The doctor comes every Thursday if you need him. The dentist came in and they did a quick check.” People had clear communication plans in place, detailing any reasonable adjustments required. Guidance ensured staff understood the individual needs of each person. Changes in people’s presentation, emotional state or distress, which may indicate a deterioration in health or wellbeing was recognised. Where a person may struggle to express their pain levels, there were personalised pain scales in place, giving staff guidance on how a person may present and signs to look for.

The management team consistently monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. Regular care plan reviews enabled the management team to have full oversight of the health and social care needs of all people. People and their relatives were involved as partners in their care and supported to maintain their independence around decision making. One person said, “They ask us if we’re happy with the food, activities and care and ask us for ideas.” The service regularly and proactively sought the opinions of people and their relatives. This was carried out with a regular meeting on each floor of the service to gain feedback from people and their relatives. One person said, “We have a residents’ meeting every other week and I’ve been to the coffee morning chats.” A relative told us, “They’re very good at keeping in touch plus letting us know about any changes.” The management team also used questionnaires to reach relatives and people who may not be able to participate in planned meetings. Records showed the management team had listened to the feedback from these and used this to look at what was working well, and where changes needed to be made.

The management team always carefully explained to people their rights around consent, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment. We saw decisions were in place to ensure all people’s rights were upheld. The service championed informed consent. People told us that staff asked for consent before carrying out any personal care. One person said, “They [staff], always ask me first if it’s ok to do something. I appreciate that, they don’t just muscle in.” Another person said, “They ask first all the time, it’s very kind.” Whilst another person told us, “I’m always asked permission before hoisting me or providing any care.” The management team had ensured they were working within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.