- Care home
Spring Lake
Report from 12 July 2024 assessment
Contents
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
The rating has improved from requires improvement to good during this assessment. People's needs were assessed and planned for in a person-centred way. People were supported to stay healthy and access healthcare services when needed. The provider assessed people's mental capacity and made decisions in their best interests. Staff worked with external professionals to provide care and support which reflected best practice. Staff spoke positively about working at the home. They said they were well supported by their colleagues and the manager. Staff said they worked collaboratively to help meet people’s needs.
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.
Assessing needs
Family members told us they had been involved in the care planning process. A care needs assessment had been carried out before people lived in the home.
Staff told us people's needs were clearly recorded in care plans and this helped them understand people’s needs and to provide care and support to people appropriately. The manager told us they regularly reviewed people’s care with the involvement of their family members and care professionals.
Care records included clear and detailed assessments of people’ needs. They reflected a good understanding of people’s individual needs and how to meet these.
Delivering evidence-based care and treatment
People’s needs were well met in accordance with best practice. People were supported to develop independent living skills where possible. This was confirmed by family members. People’s care records included details for staff to help monitor health issues effectively.
Staff had undertaken training to understand best practice. This included training about dementia, autism and people with a learning disability. Staff were able to demonstrate how they implemented good practice in their work. The manager told us they kept informed of best practices and shared this information with staff during supervisions and team meetings. The manager told us they worked with health care professionals. We saw evidence of this in people’s care notes. For example, if a person had a medical appointment this was recorded in the person’s care records. The manager told us they followed evidence based best practice. In one care plan we saw a reference to the speech and language team (SALT) assessment which had made various recommendations about supporting the person.
Care plans were informative and incorporated good practice guidelines. The manager kept themselves informed about changes in legislation and guidance. The manager supported staff to help them deliver evidence-based care. People were supported with future planning where this was possible. Staff monitored and evaluated people’s outcomes in a meaningful way and adapted the service where needed to help meet this. Staff followed guidelines established by other healthcare professionals for example, from district nurses or the SALT team. Staff supported people to eat and drink appropriately and when supporting them to move. Staff were provided with clear guidance and additional training when needed. This had helped staff to deliver more appropriate care.
How staff, teams and services work together
Family members told us staff worked well together and had confidence that staff would contact health care professionals if required. Family members spoke positively about the knowledge and competence of care staff. A family member told us, “They [staff] know [my family member] very well. They know how to care and support [them]. They understand [them] and [their] needs.”
Staff told us they were supported in their work. They told us there was good communication between staff and they felt comfortable reaching out to their colleagues and management for support. A member of staff told us, “Communication is good in the home. We work as a team so that helps. Communication is key when we work together.” Staff we spoke with had good knowledge of people and what other professionals were involved in their care. For example, they knew if a district nurse was visiting a person and this was clearly documented on care records.
We obtained feedback about the home from care professionals. A care professional told us, “They appear to be very responsive to [person’s] individual care and support needs but most importantly [person’s] emotional needs.” Another care professional had carried out a monitoring visit and had found some areas that needed to be addressed. This care professional explained that the manager seemed willing to make changes and improve the service and said they were receptive to feedback.
Appropriate systems were in place to help keep staff informed of changes in the home and with people’s needs through regular communication. This was done through regular handovers, meetings and daily logs. Staff worked well as a team, sharing information with one another as necessary to help ensure people received continuity of care. The provider had good communication avenues developed with the funding authorities, people they supported as well as family members. Evidence of communication records were seen in people’s care plans.
Supporting people to live healthier lives
Family members told us they thought people were supported to stay healthy. Staff accompanied people to appointments if needed. They told us staff liaised with other professionals and helped to keep people healthy.
Staff monitored people and recorded their progress on daily notes which were held electronically. This included areas such as nutrition, hydration, activities, health concerns and appointments. This helped staff to respond to people’s changing needs promptly and make sure people receive the appropriate support. The manager informed us that staff supported people to live a healthy life.
There was an effective system in place to help ensure people’s health and well-being was monitored. Care plans included detailed information about people's health conditions. This information helped ensure staff knew how to safely care for people and meet their needs. Staff carried out a skills and development review for each person. The aim of this was to minimise obstacles to people and brighten their lives. These included personalised information on communication, social interaction, breakfast, independent living skills and cooking.
Monitoring and improving outcomes
Family members told us the service was responsive when people's needs changed. They told us staff monitored and checked people's wellbeing.
The manager explained they had worked with families and others to support people when their health deteriorated. For example, monitoring changes in weight, nutrition, or fluid intake. They said that care workers informed the manager about changes and made clear records.
Staff completed daily notes to show how they had cared for people. These were reviewed by the manager. People using the service and family members had access to these records. Information about individual people whose needs had changed was discussed at team meetings so they could plan for these changes.
Consent to care and treatment
Family members told us people were given choices and supported to consent to their care and treatment where possible. Family members were aware of the restrictions in the home and raised no concerns about these. A family member told us, “I am not worried about access restrictions issues in the home. I understand they have to balance people’s safety. I attend a yearly deprivation of liberty meeting. I am comfortable with the arrangements.” Another family member said, “They need to keep doors locked to keep [my family member) safe. It is safer with locks in the home.”
Staff had undertaken training about the Mental Capacity Act (MCA). They understood how to present information to enable people to understand this and make choices about their care. Staff we spoke with were aware of the importance of making decisions in people’s best interests and not imposing unnecessary restrictions on people. A member of staff told us, “We work in people’s best interest. Our aim is to do things in their best interest for them.”
The 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 MCA 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 make 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 Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS) We found the provider had assessed people’s mental capacity to make decisions. All the people in the home were non-verbal and people’s family members were involved in making decisions in people’s best interests. Decisions made were documented. Appropriate legal authorisations were in place to deprive a person of their liberty. The manager stressed the importance of finding a balance between people’s safety and restrictions in the home. The manager provided documented evidence of the considerations made to help ensure that the least restrictive options were implemented in the home. Positive and proactive support plans were in place for all people. These were implemented alongside a risk management plan. The aim of these were to proactively and reactively manage risk and support the reduction of restrictions to people.