Halland 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’s support needs were assessed and reviewed on a regular basis, to help ensure their needs continued to be met. However, improvements were needed to ensure people’s care plans included all the relevant information. Key worker reviews were being developed to support people to identify goals and aspirations but these had not been fully implemented. Staff were aware of the importance of asking for people’s consent before supporting them and ensuring their wishes were respected.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received mixed feedback from people’s relatives about reviews of people's support needs. Some relatives told us they were involved in reviews others were less involved. One relative told us, “I am not aware of a care review.” However, other relatives told us how they attended care reviews, or if unable to attend were provided with copies of the review and asked for their feedback and thoughts to ensure they remained involved.

The management team told us people’s needs were regularly reviewed. There were weekly management meetings which included the provider. Staff told us care plans were reviewed monthly or more often if people’s needs had changed. Staff told us people and their relatives were involved in care reviews.

Pre-admission assessments were completed to ensure people’s care and support needs could be met before people moved into the home. Reviews of people’s needs and care plans took place regularly. Although care reviews took place updates to care plans did not always happen in a timely way. This meant current information was not always available to staff. However, staff knew people well and were aware of their current needs. Where we identified care plans that did not reflect people’s current needs, these were addressed promptly.

One relative told us how staff were working with their loved one and other professionals to ensure they received the appropriate support. Another relative told us staff responded promptly to any changes in their loved one’s health needs.

Staff told us how they used the knowledge gained from their training to support people appropriately. For example, supporting people with specialist diets, following guidance from the speech and language therapists (SALT). The management team told us staff had received training specific to the needs of people living at the home, for example PBS. The management team and staff told us people’s care was regularly reviewed to identify any changes to support needs.

Records showed the use of nationally recognised tools for example MUST for monitoring weight and Waterlow score for assessing people’s risk of pressure damage. Staff received regular training to help ensure they understood the current standards to support people effectively. People’s care and support needs were regularly reviewed but care plans and risk assessments did not always include details of the most current support required.

In general relatives told us staff teams worked well together to help ensure good outcomes for people. One relative gave us examples of staff ‘perseverance’ working with other teams to ensure their loved one received the support they required. Some relatives told us they would like to see improvements in communication as on occasions messages were not shared across the staff team.

Staff told us about changes in the way staff teams worked together. They told us how Halland House was divided into 3 separate ‘houses’ and there was a designated staff team to each ‘house.’ Whilst there was some flexibility in where staff worked, this helped ensure people were supported by a consistent staff team. The management team told us they were committed to working with external services to provide the best outcomes for people.

Feedback from external professionals involved with the service told us in general there was a good working relationship. One external professional told us, “In regard to the service responses they do seem to respond with prompt attention to any concerns raised and provide a response in a timely manner. They also take on board suggestions made to improve practice and wellbeing.” Another external professional told us how they had worked with staff at Halland House to help ensure they had the knowledge and skills to provide appropriate care and support to people. They said that staff had worked with them, communication had improved and this had a positive impact on the support people received.

Care plans and records showed that referrals and ongoing discussions took place regarding people’s health and social care needs. There were regular internal and external meetings to discuss people’s needs and ensure appropriate services were contacted for support.

People were supported to stay healthy. Relatives told us their loved ones were supported to maintain and improve their health. One relative described how, with support from a physiotherapist, their loved one’s risk of falls had decreased. People were supported to attend regular health appointments. One relative told us they would attend with their loved one if able otherwise staff would support them.

Staff told us there was a good relationship with the local GP. This included a weekly ‘virtual’ ward round where each person’s needs could be discussed. If people’s health needs required more prompt attention then the GP would be contacted at that time. Staff had a good understanding of people’s health needs and when to contact the relevant health professionals. They told us people attended regular health appointments for example, optician, dentists and chiropodists and were supported to attend NHS screening programs.

Peoples care plans and records demonstrated that referrals and ongoing discussions took place regarding people’s health and social care needs. Where people required regular health checks, such as blood tests, related to their health conditions records showed that these were taking place. Systems were in place to ensure people and families were involved, as far as possible, in health care decisions and treatments. For example, we saw staff had completed a pictorial social story to explain to a person a procedure they were due to have at the hospital. This helped ensure the person was as informed as possible, in a way they understood, before they went to the hospital.

People’s relatives told us about actions that had been taken to improve outcomes for people. One relative told us that staff had supported their loved one to start cycling and this had improved their muscle strength and mobility.

Staff gave us many examples of how the support they provided had improved outcomes for people. This included improvements in mobility, reductions in incidents as people were supported appropriately when they were anxious or distressed and identifying people’s preferences to different dietary textures which encouraged them to improve their dietary intake.

Previously staff had identified goals that people may like to achieve, for example certain activities and holidays. However, these had not been recorded to allow staff to identify how to support people to reach their goals or whether they had been achieved. This was being addressed and people were being supported to set goals in key worker review meetings. However, this had not yet been fully implemented for everyone. Records of key worker reviews were not on the electronic system which meant some staff may not be aware of individual goals. This is an area that needs time to be fully implemented and embedded into everyday practice.

People’s relatives told us their loved ones were given choices about their support and what they did each day. One relative gave us the example of when a decision had been made in their loved one’s best interests. However, their loved one had expressed, through non-verbal communication that they did not like the decision that had been made on their behalf. The relative told us how staff had worked with their loved one and the decision made had been amended and their loved one was happy with the outcome. The relative said, “They (staff) were really acting in [name’s] best interest but [name] wasn’t happy so staff listened and acted.” Relatives were aware when their loved ones had Deprivation of Liberty safeguards in place.

Staff understood the importance of giving people choices and told us how they did this each day. One staff member said, “Although people have a daily planner if they don’t want to do what’s on the planner or eat what’s on the menu then we will change it to what they want.” However, some staff told us that although people were supported to make their own choices on occasions they said staff make the ultimate choice. An example given was, if a person wanted to have a lay-in this was supported but staff would then encourage the person to get up after a short lay-in. One staff member said, “If people want to stay in bed all day why shouldn’t they?” This was raised with the management team who were clear that people’s choices should always be respected. We identified this as an area to monitor and ensure choices made by staff are in people’s best interests and with a clear rationale.

Where people were deemed not to have capacity Mental Capacity Assessments and best interest decisions had taken place to ensure decisions made were in the best interest of the person. There was oversight of DoLS, applied for, authorised and conditions.