Nyton 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

People’s care, treatment and support achieved good outcomes and promoted a good quality of life. Peoples’ needs, and choices, were assessed and considered people's diverse needs and preferences and were supported to live healthier lives. People were supported in accordance with the Mental Capacity Act. Staff demonstrated an understanding of the need for consent and supporting people to make decisions about their care. Staff and teams worked closely to ensure timely and effective 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.

Peoples’ needs, and choices, had been assessed and took account of preferences for their support. Protected characteristics and diverse needs under the Equality Act formed part of this process. For example, people’s religious needs and preferences were captured. Each person had a full and completed assessment in place, which people confirmed that they, and their relatives, were involved in. Each assessment included a review of their capacity and ability to communicate their needs and wishes. People spoke positively about their introduction to the home, the process of capturing their care and support needs as well as their wishes and preferences. One person said, “Absolutely, and when I came see the place, it just felt right.” Another person said, “My friend was involved with all that. I’ve asked her to do that.”

People received care, treatment and support that was evidence-based and in line with good practice standards. Each person had a full and completed initial assessment in place, an assessment that they confirmed involvement in. Assessment of peoples care and risks were supported by use of best practice tools, such as monitoring charts, as well as evidence-based guidance such as the Malnutrition universal screening tool (MUST) to help identify those at risk of malnutrition or those above health weight range. Waterlow assessments were undertaken for some people. This is a tool used to calculate the risk of a person developing pressure ulcers or sores. People who were identified as being at risk of skin integrity breakdown were monitored with repositioning charts so that staff could reduce the risk of skin breakdown.

Information was shared between teams and services to ensure continuity of care, for example when clinical tasks are delegated or when people are referred between services. When people received care from a range of different staff, teams or services, it was co-ordinated effectively. Staff worked with multi-disciplinary teams with fortnightly rounds to assess people’s health. Actions form these resulted in making any necessary follow ups with GPs or referrals to specialist services. Staff accessed an online knowledge sharing platform for healthcare professionals working in palliative to support people at the end of their lives. One professional said, “The referrals we receive are for individuals who are displaying heightened levels of risk, and we often have to liaise with other professionals to achieve outcomes quickly and efficiently.”

People were supported to manage their health, care and wellbeing needs by staff who understood their needs and preferences. The home supported people to live healthier lives. Care plans were detailed, and person centred, and focussed on people's health conditions, the risks and what support they needed. People were supported to access to healthcare partners, including opticians and dentists. Oral health assessments had been completed for people to ensure that they could be supported to maintain good oral health. Appropriate referrals had been made to specialist services when additional health support was identified as being needed. One person said, “I’m in pain when I walk. I went to the doctor. They took me to the appointment. They’re good like that. The home had organised a second opinion and I had several x-rays.’ People at risk of choking or malnutrition were supported to maintain safe and consistent dietary needs. Referrals to speech and language therapists were made for those needing assistance with swallowing, and meals were fortified to improve nutritional intake. The chef was knowledgeable about individuals' specific dietary requirements, including allergies, preferences, and the need for safe diabetes management. One person said, “I’m allergic to certain foods and they don’t give those to me. They always know, it’s written down in their books. There’s always something I can eat.”

People’s care and treatment was routinely monitored to continuously improve it. This ensured that outcomes were positive and consistent and met both clinical expectations and the expectations of people themselves. Care plans, risk assessments were consistently reviewed and updated to ensure that safety and effective support continued. Staff monitored the progress of people’s health conditions and wellbeing to anticipate the need for any specialist support, and used evidence-based tools to make judgements on what input was needed. Training, effective communication and information sharing to and between staff meant they were clear on the standard of care expected from the provider. These adhered to legislation standards and guidance. Feedback from staff was positive and reflected the common approach of themselves and leaders to provide expected standards of care.

People understood their rights and consent to the care they were offered. Leadership prioritised obtaining the formal consent of those they cared for in various elements of their support. People were supported in accordance with the Mental Capacity Act. Each care plan included an assessment and review of people’s capacity and ability to communicate their needs and wishes. There was detailed information and guidance on how people expressed those wishes. One person said, “There’s no restrictions.” Another told us, “They always ask for my consent. If they need to change something, they always consult me.” We observed staff obtaining consent from those they were supporting in terms of choices and preferences. Staff received training on the Mental Capacity Act and understood their responsibilities regarding MCA, and the importance of people being involved and making their own decisions.