Twyford 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 62 (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. The manager told us they undertook face to face assessments before people moved to the home. One person said, “Staff visited me in hospital, and we talked about the home and the help I would need.” The provider used nationally recognised assessment tools for example, to support people’s skin integrity and nutrition.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. Staff developed care plans from the assessments, which included people’s goals and outcomes. However, whilst there was a ‘resident of the day’ system in place, meaning all aspects of people’s care plans were reviewed monthly, the people we spoke with were not aware of being involved in these reviews or having seen their care plans. People said, “There is a care plan, but I have not seen it since [name] has been here” and “The care plan is not reviewed.” In recent staff meetings, the registered manager had discussed with staff about the importance of ensuring monthly reviews were meaningful and involved people, they were monitoring this. A relative shared some feedback with us and the registered manager offered a further review of the person’s support needs in response. People had enough to eat and drink, and they were offered choices in relation to this. Various snacks and drinks were available throughout the service. Staff monitored people’s fluid intake and acted when people were at risk of losing weight.

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. On person commented, “Staff help with my diabetes by monitoring my insulin levels. They tell me the readings and if the insulin levels change. They work well with the district nurses.” We received positive feedback from visiting professionals about staff knowledge and communication.

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. Staff referred people to various health and social care professionals for input and support where necessary. For example, people saw occupational therapists or district nurses. The local GP visited the service on a regular basis to review people’s health needs. The provider worked with local commissioners to provide rehabilitation and recovery places for people. A visiting health professional told us staff referred issues to them appropriately and as expected.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves. Visiting health professionals told us staff reviewed people’s health needs with them on a regular basis. Where people’s needs had changed, we found staff had not always updated all aspects of the care plan to reflect these changes. The provider had identified this as an ongoing action within their improvement plan.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People told us they were able to make decisions about their care. People’s rights were protected as Deprivation of Liberty Safeguards (DoLS) applications had been submitted appropriately to the local authority and kept under review. Where safety equipment was used and provided close monitoring, staff sought people’s consent for this. Where people lacked capacity to make decisions, assessments and best interest decisions had been completed. However, we noted an error on one assessment and some best interest decision records were not fully completed. The registered manager confirmed people's care plans contained the required information and they updated these records. The registered manager advised they would focus on further support to staff around this.