Woodroffe Benton House

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• 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

The overall rating for this key question is good. People’s needs were assessed prior to them living at the service. Staff used nationally recognised tools to identify risks and liaised with health and social care professionals to support good outcomes for people. People were asked consent for all support interactions. People or where appropriate, their legal representatives were asked to sign consent forms to enable staff to offer support. Staff respected people’s wishes and right to decline care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and where appropriate, their relatives were involved in initial care assessments which formed the basis of their care plans. Assessments ascertained people’s wishes, preferences and health needs. A person said, “I think I remember an assessment and I definitely saw my room before deciding to move in.” Other people told us they had to the opportunity to view the service and choose their bedrooms prior to moving in.

An allocated member of staff undertook people’s needs assessments. They told us once a person moves into the service their care is under constant review and over time a person-centred care plan is developed. Staff would be asked for input once they have understood the person’s preferred way of doing things. A staff explained how this worked for the most recent person who moved in, and said, “Yesterday a senior asked me about [person’s name] the new resident as the senior wanted to do the care plan, twice I gave personal care, which is why the senior asked me, I could give the information.”

Assessments were completed before people moved to the service. This included consultation with professionals, the person and their relatives. Where available, information from the local authority would be used to contribute to the process. Assessment forms were detailed and were accessible for staff to start supporting the person. Information was passed to relevant teams, for example, a person who had been newly admitted was allergic to strawberries, catering staff had been updated with this information.

People’s health risks were assessed by staff using nationally recognised tools. For example, the malnutrition universal screening tool (MUST) was used to ascertain people’s risk of malnutrition. A private nutritionist was employed by the service to assess people’s weights and device healthy eating plans. People spoke about the food and told us, “The food is very nice and there are always choices.” Another person said, “It is alright, nothing special, although they can make wonderful cakes for special occasions.”

The registered manager explained about how they had worked closely with the nutritionist and told us people’s weights were reviewed at each monthly visit. The registered manager told us of improvements to peoples’ nutrition and weight following this approach. Kitchen staff were aware of people’s dietary requirements and explained how they adapted meals for people with allergies, diabetes or those who required different textures of food due to choking risks. One staff member said, “It’s all in the big folder and written on our board.”

Staff monitored and recorded people’s food and fluid intake. Where any concerns were raised, they referred to the appropriate health care professional, such as, the GP. People’s dietary needs including allergies and if they required a specific consistency of food was documented and also written on a wipe board for quick reference.

People received relevant support from health and social care professionals. The local GP undertook weekly ward rounds, prior to their visits staff identified people who could benefit from the GP’s input. People told us they were involved in these discussions. A person told us, “Things are discussed with me and I relay it to the family.”

Staff gave examples of how they worked with teams and professionals to ensure people received appropriate and timely care and treatment. A staff member said, “If there are any accidents, we check on the residents and if they are in pain, we will call an ambulance. They (paramedics) come out; they can take a long time but they will be there.”

Visiting healthcare professionals gave mixed feedback about how staff and management have listened to suggestions and improved people's experiences. A healthcare professional said, “When calling the care home we are finding it very difficult to get through and when we do get through it can take some time to get to speak to someone who is able to help with a query.” Another told us, “[Member of the management team] appears to have a good level of knowledge and appears passionate and dedicated to improving the staff competencies and confidence around moving and handling.”

There had been some recent changes to processes to improve channels of communication for the GP weekly ward round. Staff received training in the National Early Warning Score 2 (NEWS2) which equipped them with the knowledge to notice deteriorating health. They further received training in Situation, Background, Assessment and Recommendation (SBAR) which also supported staff to monitor changes in people.

People were supported to live healthier lives and attend health and medical appointments. A person told us, “If I need the doctor all I have to do is ask and it is arranged, my daughter is informed of any appointments too.” Another person said, “I have a lot of eye appointments and they (staff) co-ordinate it all for me.”

Staff supported people to attend appointments at hospital or within the service. Any actions or follow ups would be handed over so staff could monitor people and escalated any concerns. A staff member told us, “We have handovers, morning, afternoon and night, everything is on [electric care planning system] and we are informed in handover regarding medication changes.”

Records confirmed health and social care professional were involved to support people to live healthier lives. Staff and management liaised with various teams such as nutritionists, occupational therapists (OT) and the speech and language therapy (SaLT) team to review people’s needs and leave advice for staff to follow.

People's health and well-being were monitored by staff, when needed, staff reviewed the support they provided to promote good outcomes for people. We observed staff changing the frequency of comfort checks for a person who was at the end of life and showed changes to their health.

Staff told us how they monitored people's health needs and escalated any concerns where required. A staff member said, “Sometimes we have to call the nurse if the catheter is blocked. We check and if there is blockage on the catheter the nurse comes and flushes it. We check first for any blockage of the tubes, first we look and see if nothing is showing we encourage to drink and if nothing we will call the nurse. We record the fluid input and output, we always put down what has come out. We check that urine isn't too dark, if reddish or brownish we know we need to encourage more drinks.”

Staff monitored people and completed various charts, such as, bowel charts and position changing charts, they escalated any concerns. Where needed, healthcare advice would be sought.

People were asked for permission from staff before they were supported. Staff provided people with day to day choices and respected their decisions. A person told us, “Yes, they always call me by my name and they treat me as an adult and respect my choices.” Another person said, “They always value what I have to say and respect my wishes.”

Staff explained how they ensured people understood their rights and how they gained consent from people using peoples’ preferred communication method. A staff member said, “I always ask them, if someone isn't communicating, you look at them when you are speaking with them. I read their faces; this morning with [person], I asked her about 4 times and then she got it. It is all about how you talk to them and how they respond to us.”

Consent forms were completed by people or their legal representatives should a person lack mental capacity. Written consent was sought for various decisions including for photographs to be taken, personal care to be delivered and for personal information to be shared with relevant professionals. The registered manager shared examples of where people had made decisions and exercised their rights to decline. For example, a person at risk of choking did not wish to have thickener added to their drinks. Staff liaised with the relevant health care professional and the person’s decision was respected.