Marine Park View

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 prior to using the service and reviewed on an ongoing basis, to ensure people’s needs were met. Passports had been prepared with relevant information if people moved between services to help ensure people’s needs were understood and continued to be met. Care plans were developed for each identified care need and staff had improved guidance in care records on how to meet those needs. Staff worked well with other health and social care professionals to ensure people’s care and treatment needs were met. Records included specialist advice and guidance, that had been obtained where people had additional support needs such as from the speech and language therapist or mental health team. Assessments were carried out, around people’s mental capacity and care records contained all relevant information and were documented in line with guidance. Staff ensured that people were involved in decisions about their care. They knew what they needed to do to make sure decisions were made in people's best interests. Advocates were involved as necessary. Systems were in place to ensure people received varied and nutritious meals. Improvements had been made to people’s dining experience and to menus and the variety of food in consultation with people.

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 told us their care needs had been assessed and they were involved in care planning. People said staff consulted with them knew their care and support needs. Their comments included, "Staff discuss the plan, we do not talk about it every day, but staff ask how I am doing." "Staff ask what I want, they do what I want." "I get the care I need, staff do not rush me."

Systems were in place to ensure people's care and support needs were met. Staff used a range of assessment tools to assess and monitor people's care needs, health and medical conditions and well-being. People’s needs were assessed prior to using the service and reviewed on an ongoing basis. They had risk assessments in areas where it was identified they may be at risk such such as their mobility, nutrition and pressure care. Care plans were developed for each identified care need and staff had guidance in care records on how to meet those needs. Care plans included specialist advice and guidance, that had been obtained where people had additional support needs.

Staff told us there were effective systems in place to assess and monitor people’s needs. This included handover meetings between incoming and outgoing staff on shift, staff meetings or and daily huddle meetings. A staff member commented, "We work as a team now, meetings happen and we discuss people's care and support." Staff knew people well and demonstrated compassion and understanding to people they supported. A professional commented, "In general I feel that the residents are now better known by the staff who work at the home irrespective of who is on shift or attendance at the multi-disciplinary meeting. If information is not available at the time it is easily accessible and staff have a clear understanding of people's care plans as well as when these need to be reviewed or are expiring."

People told us they were asked about their care and support requirements. A person commented, "Staff ask me what I think" and "I am kept informed. Staff always take an interest, they tell me know about things, they keep an eye on people here." People were positive about the improvements to the menus and variety of food and snacks. They said there were enough options and variety, as well as snacks being available throughout the day. Their comments included, "There is a choice of two things at dinner time. The food is good," "Staff weigh me, it is usually every week,"and "The food is lovely, there is plenty."

The manager and staff told us people’s care was based around what is important to them and according to their preferences. Staff knew people’s care and support needs, including their dietary preferences and nutritional needs. Staff were aware of the best practice to support people and kitchen staff took the lead from care staff at times regarding the required level of modified diet. A member of staff commented, "We have a copy of people’s nutritional needs documented in a folder in the kitchen. People now get a birthday cake, for their birthday and pop is available, if they want. There is no problem with the budget for food." Another staff member told us, "There is more choice for the people living here, activities, food. More person-centred than before, more flexible instead of routine, there is access to snacks, no restrictions, as many as people want."

Care records accurately reflected people's care and support needs. The service made timely and appropriate referrals for specialist support from other professionals such as the GP and the speech and language team (SALT). Care plans contained information about people’s nutritional needs and if a person’s diet was modified. Records were completed to document any staff intervention with a person. For example, for monitoring a person’s nutrition and hydration. People’s weights were well-monitored for risks of malnutrition. Specific nutritional care plans were in place to ensure people were able to enjoy the meals they wanted. Systems were in place to ensure people received varied meals at regular times. Improvements had been made, to menus, in consultation with people to introduce more variety. Quality improvement systems were in place, which included regular audits and feedback from people and staff to ensure people received safe and effective support at all times.

Positive feedback was received from professionals who were involved with the service. A professional commented, "Great to see the charts and to have access to quality information at a moment's glance. Keep up the good work." Another professional told us, "The new manager took onboard the need for clear assessment including a history for each person being supported ensuring the care team and external stakeholders are able to read about the person before any intervention."

Staff told us they worked well with each other and external services and were supported by management. Referrals were made to relevant specialists to obtain assessments and support for any additional care and treatment needs people may have. Staff felt communication was effective and regular multi-disciplinary meetings took place with involved professionals to discuss any additional care and treatment needs people may have. Staff followed the advice and guidance provided from the meetings, to ensure people's changing needs were met. A staff member commented, "We now have a really good relationship with other professionals, feel listened to."

Staff made timely referrals and worked well with other agencies to ensure people's treatment needs were met. A 4 weekly multi-disciplinary meeting was held with health care professionals to ensure people's healthcare needs were met. An advanced nurse practitioner, also visited the home weekly to provide support. Comprehensive information was available in people's care records to ensure that people's needs could be met safely and in an effective manner if they needed to move between services. For example, if a person with diabetes was admitted to hospital a diabetic passport was prepared. Where people may not communicate verbally, a passport included information about their preferences, things of importance to them as well as the necessary medical information. People were escorted by staff or relatives to appointments, so they did not attend alone. Staff handovers were completed during shift change, which included tasks completed, tasks outstanding and the well-being of people.

People told us they were supported to access health care. Their comments included, "They would get the doctor, if I'm off colour, not feeling well, staff are on the ball", I see the optician, I have new glasses, I went to hospital about the cataracts" and, "I feel champion." We saw that people were encouraged to drink and eat a balanced diet and were encouraged with activities. One person told us, "Staff encourage us to keep healthy. I have had plenty of exercise."

Staff told us people people were supported to ensure their health needs were met. A healthcare professional told us, "Staff make appropriate use of out of hours services such as the care home advice line on a weekend, the recovery at home team and the team for people with mental health, dementia or behavioural issues. I feel that our GP practice have had less acute/urgent contacts due to the proactive nature of the care home staff." A member of staff commented, "I have done on line activities training courses. I plan to do seated movement, and am checking the exercises are suitable for the residents."

People’s healthcare needs were met appropriately. People had access to health professionals when required. Staff worked with a range of other professionals, including GPs, district nurses, speech and language therapy and social workers. Care plans were in place to promote and support people's health and well-being. There was effective communication between staff and visiting professionals and staff followed guidance provided to ensure people’s needs were met. Daily notes documented what support was provided to people.

People told us they were supported to access health care. Their comments included, "They would get the doctor, if I'm off colour, not feeling well, staff are on the ball", "I get the chiropodist, and see the dentist," "I have new glasses, I went to hospital about the cataracts" and, "I feel champion." We saw that people were encouraged to drink and eat a balanced diet and were encouraged with activities. One person told us, "Staff encourage us to keep healthy. I have had plenty of exercise."

People told us the care they received was good and it made them feel comfortable and safe. People also told us they felt they could do what they wanted, and staff respected them as individuals. Some relatives feedback to the provider described how the care provided by staff improved people’s quality of life, general health or mood.

The manager and staff told us peoples outcomes were always monitored through daily observations and reviews such as key worker meetings. During reviews, care needs were discussed to improve outcomes. Regular audits were also carried out to monitor and improve outcomes.

Systems were in place to monitor and improve outcomes. Care plans were personalised to ensure outcomes could be met in ensuring people received safe and effective support. There was a monthly evaluation of risk assessments and people's care plans, to ensure they accurately reflected people's needs, with appropriate guidance for staff about the support people needed. Reviews were carried out regularly to ensure peoples support and outcomes were monitored. Audits were carried out, with an action plan in place, to ensure people received personalised care according to their needs to ensure there was a system of improvement and improving outcomes for people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People told us they were asked for their choices and staff respected their decisions. A person commented, "Staff ask what I want, they do what I want." Another person told us, "Staff ask everyday what I want for breakfast."

Staff knew how to support people in a way which respected their decisions and supported them to make choices. They knew what they needed to do to make sure decisions were made in people's best interests. The manager and staff were aware of the principles of the Mental Capacity Act (MCA) and the need to ask for consent. Staff empowered people to make their own decisions about how their day to day care and support was provided. They understood people’s capacity to make decisions through verbal or non-verbal means. We observed positive interactions between staff and people. Staff involved people in everyday decisions and acted in people's best interests. Staff explained what they were doing and asked people's permission before providing support.

The Mental Capacity Act 2005 (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 Act 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. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Staff supported people in least restrictive ways. Records around people’s capacity contained all relevant information and were completed in line with national guidance. [DoLS] authorisations were closely monitored by the management team.Records showed mental capacity assessments had been completed with people and their representatives. People’s capacity and ability to consent was taken into account, and people and their representatives had been involved in planning their care and support. Where people could not make decisions and consent to their care, there were processes in place to make sure any decisions would be made in their best interests. People had the involvement of an advocate when family or friends, were not available.