Hill 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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. People’s needs were assessed when they started living at the service and reassessed regularly. Staff worked with health professionals to help promote good health outcomes for people and support them to live healthy lives. People were supported in line with the Mental Capacity Act (MCA).

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.

The service now made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People’s needs were assessed when they started using the service and reassessed regularly. One relative said, ‘‘When [family member] first moved in there was a lot of work done to help make sure staff knew them well and how to support them in ways that were important to them. We also talk about how things are going on a regular basis.’’ Staff told us how they got to know people by reading care and assessment plans and spending time with them. They spoke to the management team if they noticed changes to people’s needs so they could be reassessed. The manager told us they had updated their assessment policies to help make sure they were able to fully meet people’s needs before they started living at the service. They had identified this as an issue beforehand as they were supporting people whose needs could not be met by staff at the service. This assured us the manager had taken action to help make sure previous issues were avoided as far as possible.

The service now planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People told us staff supported them according to how they wanted to be supported and understood their needs. One person said, ‘‘I can be a little forgetful now, but staff know how to help me with this and make sure I know what is going on.’’ A relative told us, ‘‘[Family member’s] needs have changed a lot recently. [Staff] keep up with these changes and support them as best as possible. I have confidence they know what they are doing.’’ Staff told us the training they had helped them understand how best to support people living with health conditions such as physical disabilities or dementia. They explained how to support people in the best way possible in line with their support needs. The management team now researched and kept up to date with best practice guidance and legislation and shared this with the staff team.

The service now worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. People and relatives told us staff worked well together and also linked with health professionals if people needed more support. One person said, ‘‘I was having some trouble with [health condition] and staff organised [health professional] to come and see me. They followed their advice, and I am much better now.’’ A relative said, ‘‘The staff team seem to really gel and work well together. There is a really nice atmosphere and staff always look happy to be at work.’’ Staff were positive about how well they worked together. They told us the management team had supported them to come together as a team and work together to support people in the best way possible. The management team held regular team meetings and worked directly with the staff team to promote working together. Advice from health professionals was recorded and shared with the staff team. People’s care plans were updated in line with advice from professionals.

The service now supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support. People and relatives told us staff supported them to be healthy. They were positive about how staff supported them to eat and drink enough and to follow any advice from health professionals to help them live healthy lives. One person said, ‘‘The food is lovely, and you get a choice. We choose it at lunchtime. You can sit where you want, and you can get a drink when you want. They are always bringing cakes and biscuits round. I don’t get hungry,’’ A relative said, ‘‘[Staff] rang to let me know [health professional] had been in to see [family member] and what they would be doing to support them with this.’’ Staff knew how important it was to support people to be healthy and how they monitored people’s food and fluid intake if this was necessary. They also explained how people felt better when they spent quality time with them, and they had been empowered to do this by the management team. The cook at the service was knowledgeable about how to support people in line with their dietary needs. Processes were in place to support people to live healthy lives such as aspects of their support being monitored closely by the staff team. People had been supported to put on weight and maintain their health whilst living at the service.

The service now routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. People and relatives told us staff supported them to have good health related outcomes. One person said, ‘‘[Staff] know I need a lot of support with [health condition]. They make sure I always have a drink and talk to me about it all the time which makes me feel safe.’’ A relative explained how they had been worried about their family member, however staff had contacted a health professional and worked with them to put support in place. As a result, their family member had a positive health outcome and was now feeling better. Staff told us how they followed care plans and advice from professionals to help people have good health. For example, monitoring people’s food and fluid intake or making sure they took part in regular exercise. The management team now reviewed people’s care records to help make sure people were being supported in line with their support needs. They took action if necessary, such as referring people to health professionals.

The service now told people about their rights around consent and respected these when delivering person-centred care and treatment. People and relatives told us staff asked for their/ their family members consent whilst supporting them. One person said, ‘‘The staff always let you know what they have come to help you with and if you say no, they respect that.’’ Staff were trained in the MCA and knew how this impacted their job roles and how they supported people. Where people may lack capacity, detailed assessments were put in place guiding staff how to support people to make choices. Decisions were made in people’s best interests with the input of those close to them and relevant professionals. These capacity assessments and best interest decisions were recorded, understood and followed by the staff team.