David 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

We assessed all of the quality statements within this key question. Our rating for this question has improved to Good. People’s needs were regularly assessed to ensure support continued to meet their needs. Staff worked with other healthcare professionals to ensure people’s health and wellbeing was supported, they received good nutritional support and achieved good outcomes. Staff worked in line with the principles of the Mental Capacity Act 2005. However, MCA assessment documentation was not always detailed enough to captured what was discussed.

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 were involved in assessing their needs. People’s care and support needs, and their intended outcomes, were understood and met by staff. One person told us, “I think the staff do understand my care needs and these are being met.” Another person said, “I get involved in my care plan. I make sure I tell them what I want.”

Staff understood people’s needs well and how these should be met so that people experienced positive outcomes. Staff had easy access to people’s care records and used the information within them to provide the care and support people required. The home manager supported staff to provide care and support in line with people’s needs. They told us, “We have supervision and team meetings and we have a session where [staff] give updates about people and how they are and any concerns they have.”

Processes were in place to assess people’s needs. This included liaison with the person and their relatives, as well as any previous social care providers in order to gather as much information as possible about people’s needs and how they wished to be cared for.

People’s care and support was planned and delivered in line with their wishes and preferences. People were happy with the care and support they received because it was in line with their wishes and preferences. One person told us, “They give me the care I want. They sort it. They seem to know what they are doing.” Another person said, “I get good care and support here. It’s caring, quality care. I get to choose what happens to me and I like that.”

Staff were supported to stay up to date with training in topics relevant to people’s needs. This ensured the care and support they provided to people was based on current evidence based good practice and standards. The provider made sure changes were communicated to staff that might impact on the care and support they provided. The quality assurance lead told us, “We use our quality framework, which I am responsible for, and this is derived from national guidance. We sign up to a lot of services and we get information from the LA and from other agencies. Any changes that come in, I make sure these are filtered down to the staff.”

Processes were in place to ensure evidence-based care was delivered. This included liaising with specialists when the staff team felt they needed additional help and advice about how to appropriately care for someone. Regular staff training ensured staff were informed about best practice guidance.

People experienced continuity of care when they started to use the service because the provider worked with them, and the people and agencies involved in their care, to assess their needs and have care plans in place to meet these.

Staff were supported to deliver the care and support people required as soon as they started to use the service. The provider made sure staff had access to information about people’s care and support needs and informed about how people’s needs should be met.

Healthcare professionals felt there was good joint working. They told us, “Staff were prompt in acting on the holistic approach recommendations and were able to commence medication changes in a timely manner…The Home Manager always asked me for a few minutes at the end of my reviews, to ask for feedback and further advice. Another thing that I appreciate at David House is that they also know when to ask for help or advice.” Another professional said, “[The RM] takes advice seriously, communicates effectively with relevant parties to support the residents, and promotes service development.”

Systems were in place to incorporate advice from other health and social care professionals working with the service into people’s support plans so staff had access to this information and were able to help deliver continuity of care.

People were supported to stay healthy and well. They were assisted to attend their scheduled appointments with healthcare professionals to meet their healthcare needs. People were supported to eat and drink enough to meet their needs. One person told us, “The food is very good. I get medication when I need it.”

Staff understood how people should be supported to stay healthy and well, in line with their assessed needs and preferences. They knew when and how to seek support for people if they were unwell. A staff member told us, “I make sure people have proper nutritious food, plates are well balanced and they have plenty of fluids.” Another staff member said, “I make sure people are eating, take their medication and getting exercise.” The home manager told us, “We have experienced staff who know their people well and can pick up any changes to people quickly and report this.”

Processes were in place to review people’s health and access healthcare services when needed. This included supporting people to regularly see their GP and other community healthcare services, as well as more specialist services when required.

People’s care and support needs were discussed and reviewed with them at regular intervals to ensure these were continuing to meet their needs and achieve positive outcomes. One person told us about the support they had received from staff to help them improve their health and wellbeing. They said, “Before I came here…I didn’t look after myself and I was very withdrawn from everyone. I just broke…then a light switch got turned on and I haven’t felt like that since then and things are so much better for me now. I have felt so supported by the staff team through all this. I can do the things I like now and I get positive encouragement.”

Staff understood how to support people to help them achieve positive outcomes in relation to their care and support needs. A staff member told us they did this, “By following the care plan and listening to people about what they want.” The home manager told us daily records were maintained by staff which helped them assess and review the support provided to people and to highlight any concerns staff might have about people’s health and wellbeing. They said, “Staff complete daily notes and we emphasise to staff the need to have the right information which is passed on to the right people.”

There was regular review of people’s needs and the support provided to ensure it continued to meet their needs and achieve positive outcomes. This included review with other healthcare professionals working with the service. One professional said, “I asked staff what would they like to achieve with my support, and their reply was that they want to improve the care they give to [the person] and they want him to feel better.”

People were supported to understand the care and support staff wished to provide them. This enabled people to consent to this if they wished. People could refuse to receive care and support and staff respected their decisions about this. One person told us, “They ask for my permission before they do anything.”

Staff empowered people to make decisions about how their day to day care and support was provided. They understood people’s capacity to make decisions about their care and support through verbal or non-verbal means. A staff member told us, “You always ask for permission before you do anything.” Another staff member said, “I talk to people and ask for permission before doing anything.”

Processes were in place to review people’s capacity to consent to care and this was discussed as part of the Deprivation of Liberty Safeguards (DoLS) process. We saw applications were made for authorisation of deprive people of their liberty when this was considered necessary to ensure people’s safety. Whilst there were mental capacity assessments undertaken by the provider, we found the records accompanying these decisions were not detailed nor specific to a particular decision.