Red Oaks Care Community

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 good. At this assessment the rating has changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.
Care plans were in place and included details such as mental capacity assessments, communication needs, and personal preferences. However, records contained contradictions and gaps.
A relative told us they were involved in the admission process, and said “They discussed [person’s] needs with me when [they] came in,” while another person told us, “I went through a screening process when I came in.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

National tools such as the malnutrition universal screening tool (MUST) were used, and some care plans reflected best practice for diabetes and end-of-life care. However, gaps were identified in applying guidance. For example, a person at high risk of choking was observed eating quickly without clear strategies in their care plan to mitigate this risk. Another person’s stoma care plan lacked detail on how to clean the site or monitor for infection, despite previous concerns noted by stoma nurses.The provider told us they had made improvements to this person’s care plan following our inspection.PRN, or ‘as required’ medication protocols were not always person-centred and failed to explain how staff should identify pain or constipation in people before administration.

The provider 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.

Staff, teams and services generally worked together to support people, although improvements were needed in communication and coordination.
Staff described good teamwork and attended regular morning meetings to share priorities. One staff member said, “It feels like a family here. We talk about changes every morning.” Nurses reported they could escalate concerns and felt supported by management. There was evidence of engagement with external professionals, such as GP visits and speech and language therapist (SALT) assessments.
Observations showed staff collaborated effectively during lunch, supported people calmly and responded promptly to signs of distress.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Care plans included details of dietary preferences and hydration needs, and staff were aware of allergies and special diets. However, monitoring was inconsistent. For example, food and fluid charts were not always completed, and 1 person’s nutrition plan lacked strategies to address rapid eating despite a choking risk. This person required level 1 thickened fluids however, there was no detail on the amount of thickener to make drinks recorded within their care plan.
Relatives told us they were informed of falls and health concerns promptly, and people said they enjoyed the food and had choices. However, observations highlighted missed opportunities to promote independence and healthier living, such as limited physical activity and lack of engagement for residents upstairs.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The provider failed to ensure effective monitoring of people’s care and treatment, resulting in significant risks to their health and wellbeing. Records showed some clinical monitoring such as blood glucose checks were taking place.Contradictions in repositioning instructions and lacking guidance around stoma care indicated poor oversight. This placed people at the risk of harm though preventable infection.
Staff told us audits were completed, but evidence showed these were ineffective in identifying risks such as soiled pressure cushions, broken equipment, and multiple infection prevention and control concerns. At the time of inspection, many risks remained. This meant people continued to be exposed to preventable risks that could negatively impact their health, safety, and overall wellbeing.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider made sure people’s rights around consent were respected, although some care records contained contradictory information. Mental capacity assessments were completed and were decision-specific, with best interest decisions recorded for covert medication. Decisions had been documented regarding people’s wishes around medical intervention for people at the end of life. However, some care plans contained conflicting statements about people’s mental capacity.
Relatives confirmed they were involved in decisions, and staff described how they sought consent before providing care where possible. Observations showed staff explaining tasks and offering choices, although this varied depending on cognitive ability.