Dormy 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 were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service were in place to support this practice. The manager worked with staff to ensure care plans and related documents had specific information about people, their needs and how to manage any conditions they had. People and relatives were involved in planning their care and were informed of any changes in health or wellbeing. Relatives were positive about the staff and the service. People were able to access healthcare professionals such as their GP and other services specific to their needs. The service worked well with other health and social care professionals to provide care for people. Professionals noted to us a clear positive change and improvements in the service. Staff supported people to make decisions following best practice in decision-making and respected their rights to refuse support. People and relatives told us staff were caring, friendly and kind, and we observed this. Staff understood how to treat people with care, respect, and consideration.

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 and their families were involved in the assessment of their needs, and support was provided where needed to maximise their involvement. People’s individual needs have been appropriately assessed and were fully understood by the service. Relatives told us people’s needs were met and understood by the staff team, and they were regularly informed of any changes. One relative added, “We have had a review of the care plan. The strange thing is, if I could have written it, it would have said exactly the same thing – word for word. We are totally happy with it”.

The manager worked with the staff team to maximise the effectiveness of people’s care and treatment by regularly assessing and reviewing their health, care, wellbeing and communication needs with them. They communicated daily to ensure any information or changes about people’s needs had been noted and actioned. The manager said, “We do 6 monthly reviews with people and relatives. We send them a copy of the care plan and ask to add something and then we arrange a meeting, [with everyone involved]. We discuss it all and update the care plan and we let them know it is done and sign it to indicate that they are happy for it to be used”. Staff agreed people’s needs and risks were assessed and reviewed regularly using a range of assessment tools to ensure their needs were reflected and understood. Staff’s views were sought and considered to support people’s reviews and assessments. They agreed people and families were always involved in those processes. Staff agreed information was shared during meetings, handovers and daily communications to ensure all staff were aware of any changes. Staff felt supported and they were encouraged to share any issues or concerns with the manager.

People had care plans in place which included details about people’s needs and support. The care plans also noted to ensure people receiving care was respected, considered and at the heart of staff’s work. Assessments and reviews considered the people’s health, care, wellbeing, and communication needs, to enable them to receive care or treatment that would have the best possible outcomes. People’s communication needs were assessed, recorded in the care plans and met to maximise the effectiveness of their care and treatment.

People received care, treatment and support that was in line with good practice standards and achieved good outcomes for people. People said, “I can’t look after myself anymore and they do a good job” and “I need a lot of support and [staff] are able to give that to me here. When I need help, [staff] are there for me”. Relatives were kept up-to-date with people’s care and support and informed about any changes. People, and their relatives as appropriate, had been included in discussions and reviews around their care and how this was to be delivered. People’s nutrition and hydration needs were met in line with current guidance. People and relatives were positive about meal times and choices. A relative added, “Even the food is amazing here – the chef is excellent. I asked if it would be possible to do something for my relative’s birthday. You should have seen what they did! It was unbelievable! [the chef] organised the food and it was superb. I had not expected so much effort. They take pride in what they do”.

The manager worked and sought support from different stakeholders to ensure the care was in line with legislation and current evidence-based good practice and standards. The manager was motivated to plan and deliver people’s care and treatment, including what was important and mattered to them. This also reflected in the whole team approach to the care provision that has a positive effect on the service. The manager added, “For the moment… the first thing is turning the corner and make things better, keeping people safe, engaging people and they come out of the unit, as before they were contained. Now they are going out, involve in activities, and they utilise the garden. We did the sensory garden near my office…people like sitting there”. Staff received training, attended staff meetings, reviewed relevant guidance to ensure they were up-to-date with required standards to help them care for people in this service. People’s nutrition and hydration needs were met in line with current guidance. The manager explained how they supported, monitored and reviewed people’s nutrition and hydration needs including seeking support from professionals if they identified any risks or issues. Staff said people had choices at meals times and if anyone did not like the choices, they were able to have an alternative of their choice. Kitchen staff were able to support variety of people’s dietary needs and worked with the rest of the team together to ensure they had all the information needed.

The manager and staff communicated with people, their relatives and partners about their care and treatment that supported good practice, relevant to people’s care. Staff and the manager were using a specific system for remote monitoring in their care. This was to help support the complex care required by people. The staff would collect people’s health readings and use the remote system to share this with the dedicated health team. Depending on symptoms and care needs the team were able also escalate to the local GP practice for further support. This helped reduce waiting times on the phone and the staff were able to support and address people’s health needs promptly. The remote system worked well with the service’s own scheme to record observations. Kitchen staff communicated with the staff team on a regular basis to ensure they had the right information on what people’s diets, preferences and any specific requirements were. People could have a drink or snack at any time. We observed people always had drinks available to them and were encouraged to have those. People received support where needed with meals and drinks to maintain a balanced diet. During mealtimes, we observed people were not rushed to have meals but also were encouraged to maintain their independence with having meals. People were offered food choices including plates of actual meals to ensure people could view different option. People had drink available throughout the day in the communal areas and bedrooms.

People received care and support from the staff team who knew them and their needs well. This meant people received person-centred care that was meaningful to them. Relatives agreed the service and other professionals worked well together to look after the people. The information was shared between teams and services to ensure continuity of care and when people were referred between services. People were able to access health services without needing to leave the premises.

The manager worked in collaboration and effectively across teams and services to support people as they moved between services so that people had positive outcomes. The manager and staff had access to and used the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. The manager had clear lines of communication and records kept ensuring care was co-ordinated effectively. The manager added, “Staff speak to me as they want to get some confirmation that they do things right. We get support from Learning & Development to improve the skills and knowledge of our team members. Open communication [between us and the staff team] has had massive a contribution to the success of the home”. Staff agreed the service and other professionals worked well together to look after the people. The information was shared between teams and services to ensure continuity of care and when people were referred between services. One staff said, “[I am] overseeing safety and liaising with professionals in the multi-disciplinary teams (MDT)”. Staff agreed they had enough support, knowledge and skills to provide specific care to people with different needs.

Professionals agreed the service worked well in collaboration to ensure continuity of care and good outcomes for people. They said, “Yes, the care home is always bringing residents to the MDT when they have any concerns or just to have a different perspective things” and “Since the manager has been informed about the care home multidisciplinary team (MDT), all complex resident cases are now being brought forward for discussion and support. Additionally, the manager is now more actively engaged in requesting training when a knowledge gap has been identified”.

The manager had a process in place to support people and their relatives as they moved between using different services. When people transferred from other services, there was a process to manage initial assessments and plans of care were compiled to ensure they considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. All relevant staff, teams and services would be involved in assessing, planning and delivering people's care and treatment and staff would work collaboratively to understand and meet people's needs.

People were supported to remain as healthy as possible. Relatives agreed they were informed what was going on with people, any changes in their health or wellbeing. People were referred to various health professionals to address any health issues or changing needs in a timely manner.

The manager told us how people were supported to manage their health and wellbeing, but also to ensure people had as much choice and control as possible. The manager worked with the staff team to continuously monitor and oversee people’s needs and preferences and look after their health, care and wellbeing needs. People were involved as much as possible in reviewing their health and wellbeing needs where appropriate and necessary. Staff agreed they worked together to help people look after their health and respond to any concerns or deterioration related to their health. For example, the deputy manager noted they liaised with professionals such as the mental health team, the Integrated care boards and the Care Home Support Team to respond to people’s needs in a timely manner. Integrated care boards (ICBs) are NHS organisations responsible for planning health services for their local population.

People were supported to remain as healthy as possible. Care plans covered aspects of care including health and well-being to meet people’s individual needs. People's changing needs were monitored appropriately to ensure their health needs were responded to promptly. People were referred to various health professionals in good time to address any health or changing needs. The manager and the staff were knowledgeable and informed about people's health and wellbeing. Professionals agreed the service supported people to maintain good health, have access to healthcare services and receive ongoing healthcare support. The care and support for people's health and wellbeing was proactive and organised well.

People were valued by the whole staff team who showed genuine interest in their well-being and quality of life. Relatives agreed the managers and staff were knowledgeable and provided specific care to people as appropriate. People had care and support that was co-ordinated, and everyone worked well together. Staff supported people so they were enabled to live as they wanted to, seeing them as a unique person with skills, strengths and goals. Staff were patient and used appropriate styles of interaction with people. They were calm, respectful and attentive to people’s emotions and support needs, such as sensory sensitivities.

The manager and staff routinely monitored people’s care and treatment to continuously sustain it and improve it where possible. They ensured that outcomes for people were positive and consistent. The manager and the staff team worked together to use effective approaches to monitor people’s care and treatment and their outcomes. The manager said, “We get feedback from people and families we ask them it. We have surveys and we are doing meetings. It gives us an idea what we are doing is actually effective or there is anything else we need to do. I always call families every month and have a conversation with them or speak to people when I’m doing my rounds. That’s how I assess what we deliver is effective”. Staff said they used observations by care staff and nurses, as well as, GP reviews, and different checks to monitor people’s health and wellbeing so they could respond to any changes and ensure good outcomes for people. Staff were aware of different ways people communicated including responding to people’s non-verbal cues and body language.

The teamwork, commitment from staff and staff’s knowledge of each person supported effective approaches to monitor people’s care and treatment and their outcomes. Staff ensured people had up-to-date care and support assessments, including medical, psychological, functional, communication, and preferences. This way staff were able to support people receive the care, support and treatment they needed and wanted. Staff provided people with personalised and co-ordinated support in line with their communication plans, sensory assessment and care plans.

People's rights to make their own decisions, where possible, were protected and respected. Staff sought people's consent before providing care or support. We observed staff were polite, kind and respectful towards people and respected their decisions. If people did not want to do something or take part in an activity, the staff responded appropriately. Relatives were complimentary about staff’s support and the way they treated people. One relative added, “Yes, we are involved and we trust that the care and decisions will be made are in [person’s] best interest; if [the staff] have to make decisions without us, they will tell us straight away”.

The manager told us how they communicated and encouraged staff to assume capacity, support people with their choices and wishes, even the small details of what they liked. The manager told us they involved and consulted people, relatives, and any other relevant party to ensure the decisions made were in the best interest of the person. The manager and staff worked together to ensure people received information about care and treatment in a way they could understand and had appropriate support and time to make decisions. Staff supported people to make decisions through verbal or non-verbal means and sought people’s consent before providing any care or support. Staff empowered people to make their own decisions about their care and support and respected their rights including right to refuse. Staff agreed people, their relatives or others that matter, professionals were involved in supporting people to make decisions when planning, reviewing or managing care and support.

The manager worked with people, staff, and others to ensure people’s rights around consent were respected when delivering person-centred care and treatment. Within people’s care plans, it documented about people’s capacity and support they required with making decisions. The manager followed the process when people needed support to make decisions to ensure it was in their best interests with the right parties and professionals involved. Staff helped people make choices and decisions, using their preferred method of communication and this was done in a respectful manner. People's capacity and ability to consent was taken into account, and they, or a person lawfully acting on their behalf, were involved in planning, managing and reviewing their care and treatment. People’s views and wishes were taken into account when their care was planned.