The Old Hall

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

Staff worked to achieve good outcomes for people. This included supporting them with health issues or working with people towards different goals. The service worked within the principles of the Mental Capacity Act, supporting people to make their own decisions where possible and working in the least restrictive way possible.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

Relatives were extremely positive about how well they had been kept informed about their family members’ needs, this included their health needs. One relative said, “We are kept informed of [Name’s] appointments and (staff) update us on their health.” A further relative said, “(The Old Hall is) a safe place and they inform us (of any changes). [Name] has been in hospital and we were pleased with the support. We had a 3-way conversation initiated by 3 phones. The staff understand [Name’s] needs and likes and dislikes”

The manager told us staff were supported to look consistently at how they could improve outcomes for people. They told us there were different ways to do this. The team at the service would record issues such as a person’s response to different events, for example any health need interventions. The positive behaviour support (PBS) team looked at people's behaviours from incidents or events and involved staff on site at weekly meetings about the best way forward for each individual, and they would make changes to people’s plans together. This collaborative approach supported staff working together to improve outcomes for people. A member of staff we spoke with supported what the manager had told us. They said, “We have an app on the handheld devices and there is a form for you to complete about any incidents or behaviour event, this feeds back into the PBS work to see if we can prevent reoccurrence.” Staff also told us how the provider had initiatives in place for people with all aspects of their health. One member of staff gave an example of how people were supported with their diets. They said, “We encourage healthy options, there is a company chef supports the service - with a couple of people who are quite challenging with their dietary needs.”

The processes in place supported excellent outcomes for people. There was detailed information to show how people liked their support and how to support people to get the best out of them. For example, one person’s care plan showed how a change of room to an apartment within the service to help their independence had been successful, and what strategies staff should employ to support the person have a good day. There was evidence to show what strategies had been successfully used so they could be repeated. The staff team had been innovative in the way the had approached one particular aspect of the person’s behaviour pattern. The person tended to hoard large numbers of items in their apartment, this had caused a fire risk and put the person at risk of large items falling on them. When staff tried to address this they found conversations increased the person’s anxieties. They involved the local community police team who presented to the person as experts in their field. Together the person, community police team and staff had produced an agreement the person was happy to follow to keep them safe. Using these strategies had resulted in a significant reduction in the persons anxious behaviours. We were also sent an example of a long term goal for a person. The support needed to achieve this goal was clearly laid out for staff, with progress shown in the record.

People’s families told us they were involved in supporting people to ensure they received care in line with their consent. One relative said, “(This is) a good service, staff are keeping [Name’s] weight down and encouraging them to cook. They (staff) use picture cards so [Name] can choose what they want to eat. They (staff) are open and transparent the data is amazing and well documented. In [Name’s] reviews we see all this documented. We can say what we want in [Name’s] reviews.”

The manager told us there were a variety of ways to ensure they worked in line with the principles of the Mental Capacity Act 2005. They told us they use the picture exchange communication system (PECS) to help people make choices on things they might want. They used the aims and aspirations information they got from people and listened to their relatives. They went on to say, “The team use people's behaviours to help them understand what people want.” Staff we spoke with told us they had received training to understand their responsibilities in supporting people in line with the mental capacity act. One member of staff said, “I did the training in the induction. For the individual, it’s about making sure you are sticking to the 5 principles of the MCA, we need to make sure people can have their say and support them to communicate their decisions.”

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 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 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 with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguarding (DoLS) The provider was working in line with the Mental Capacity Act. There were clear processes in place to show people’s mental capacity had been assessed to help support individual decisions around their care. People living at the service needed different levels of support when making decisions. People were supported by appropriate health professionals, families and staff, who were involved in best interests meetings, so decisions made about a person’s care were taken in the least restrictive and safe way.