Astell Care Centre

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

People’s needs were assessed and continually reviewed with them. Staff worked together and with other health professionals to ensure people received the care and support they needed. Staff understood the principles of the Mental Capacity Act and sought consent from people. However, people had not always received a positive mealtime experience. Best practice needed to be embedded into the service on some units, including ensuring meals were hot when presented and staff provided a positive atmosphere when supporting people dining.

This service scored 71 (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 relatives felt involved with their care needs and said discussions took place. People told us the staff knew them well and knew how to assess their needs. They said they could speak to staff if something changed with the way they needed to be cared for. People told us they moved into the service smoothly and without any problems. One person said, "It was a planned admission and went smoothy."

Staff told us they knew people well and people were relaxed in their presence. They told us they had read people’s care records to become familiar with them.

A thorough assessment of people’s needs took place before they moved into the service and an admission policy was in place to support this. We reviewed 14 care records and confirmed information was transferred from assessment to individualised care planning in line with their assessed needs. Further updates were required to ensure all care records were fully up to date and transferred to the providers new paperwork.

People told us their nutrition and hydration needs were met. People generally commented that the food was good, and they received enough food and drink. One person said, "The food is excellent - smashing." However, we found the experience at mealtimes was not always good. This included one person receiving 'cold food' at lunch time, no condiments used in some of the units and a poor atmosphere on some, including no music and a dull and dreary environment. Relatives said staff at the service managed risks well and supported people who became distressed very well. One relative said, "Think the staff are good, [person] can be very hard at times, but the staff seem to cope."

Managers and staff were aware of the importance of using recognised assessment tools and how to involve people in the assessment, planning and delivery of their care so their views and preferences were included in care plans. One staff member said, "Residents are included all the time." Staff were aware of the procedures to follow in line with best practice guidance.

People were referred to specialist healthcare when needed, including Speech and Language Therapy Teams (SALT) when additional support with eating or drinking was required. Some care records needed to be further reviewed and updated to ensure they followed best practice guidelines, including updating dietary monitoring forms.

People told us staff worked well together. People said that transfers into the service went well. Families were involved and staff worked in partnership with external professionals. Relatives told us any minor issues that arose when moving in, were addressed after discussion with the management team.

Staff were involved in professional meetings with people's GPs and social workers. Staff felt that healthcare professionals received first-hand knowledge of people from the staff who cared for them.

Healthcare professionals told us they had a good working relationship with staff at the home. One healthcare professional said, "They (staff) do ask for appropriate help."

Processes were in place to show staff worked together with others. This included handovers at shift changes to ensure all staff knew of the current care needs of each person. Care plans were updated with advice from healthcare professionals, although one professional told us, "Sometimes we have to say a few times before things change." Staff meetings took place to share information and communication books were in place to ensure daily information, such as appointments were not missed. Weekly visits from GP's and community nursing staff took place. These visits meant people could be seen quicker at the initial start of any healthcare concerns.

People were supported to live healthier lives. People and their relatives confirmed appointments, for example, with GP's or hospitals were made when needed. Staff supported people with transport when necessary and arranged any other additional support required. One person said, "They get the doctor straight away, no messing."

Staff told us they supported people with any appointments they needed and also with their general health to remain healthy. One staff member told us how the team, particularly kitchen staff, had worked with one person to support them to lose some weight.

Processes were in place to confirm people were supported to maintain healthier lives. This included care plans and monitoring tools. We did find some evidence monitoring tools were not always used fully. This is addressed in the well led section.

People and relatives felt, were possible, staff improved outcomes for people. One relative told us, "(Person) tends to lean to one side. They (staff) monitor this and move (person) regularly. They have no bed sores."

Staff told us they monitored people's health and wellbeing to improve outcomes. One of the activity staff told us, "It’s not all about medicines and physical things, we need to keep our residents stimulated in other ways as it helps with overall wellbeing. Staff explained about the positive relationship with the linked GP surgery who they worked with to monitor and improve people’s clinical outcomes and ensure people’s choices and expectations around healthcare were met.

Processes were in place to monitor people's health and wellbeing and review outcomes. We received a number of case studies to evidence good outcomes for people. This included where staff had supported a person to regain their mobility and ability to walk, and where another person had regained their ability to eat independently.

People told us consent was requested prior to care being delivered and their wishes were respected. People told us they could make their own choices of what they wanted to do and when. Relatives had made their wishes for their loved ones known and these preferences had been listened to. Relatives were involved in best interest decisions where needed. Some relatives had a lasting power of attorney in place and were legally able to act on behalf of their relative in decision making.

Staff understood the principles of the Mental Capacity Act 2005. Comments included, “People have the option to make their own decisions", "You should never assume a resident lacks capacity to make any decisions, some of the more tricky ones are supported with best interest decision making with family etc." and "We all make unwise choices at times, our residents do the same sometimes."

Capacity assessments and best interest decisions were completed when needed. It was clear staff understood people may have the capacity to make one decision but not another due to the nature and complexity of the decision to be made. When necessary, Deprivation of Liberty Safeguards (DOLS) had been applied for and had either been authorised or were waiting assessment. DoLS is the procedure prescribed in law when it is necessary to deprive of their liberty a resident or patient who lacks capacity to consent to their care and treatment in order to keep them safe from harm.