Archived: Blossoms Care Home Limited

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.

People’s needs were not well assessed or supported. People’s health needs were not safely managed or considered and the oversight of this was poor. People did not always benefit from joined up care with other health professionals to ensure good health outcomes occurred. People were not always consulted or encouraged to consent to their care and treatment.

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 make sure people’s care and treatment was effective. At our last inspection we identified staff did not always have the information required to support people safely. Not all care plans and risk assessments held up to date factual information. At this inspection this continued to be a concern. The manager’s process for assessing people’s needs was ineffective. The manager told us they would complete the pre-assessments of new people and would look at; medical histories, behaviours, eating and drinking, choking, mobility, falls risk and wounds, however this had not happened: A person had moved into the service in December 2024 and their care plan missed important guidance and risk assessments about their specific health needs which left them at risk of receiving unsafe care and support.

Other people’s needs were not well assessed or supported. For example, 1 person’s care file contained documents such as risk assessments around nutrition, hydration, oral care, weight/BMI (body mass index) and Waterlow (the Waterlow tool score gives an estimate risk for the development of a pressure sore) which were all blank and contained no information. There was some information contained in the person’s care plan that the local authority had shared with the service suggesting the person had risks around dehydration due to previous UTI’s in hospital. However, there were no assurances how this information had been used or evidence the provider had completed their own assessment to implement risk assessments or information for staff to refer to, to support the care of the person.

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.

The provider did not support people to manage their health and wellbeing, so people could not 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. For example, some people were at risk of constipation. One person’s care plan stated their GP should be contacted after 3 days if they had not opened their bowels. The bowel monitoring records showed they had opened their bowels on the 11 January 2025 and the next recording was the 18 January 2025, however the GP had not been contacted. The manager showed us the daily notes for the person which stated they had been to the toilet in between this time but it was not clear if this was to open their bowels. The records around this were poor and provided no assurances about the person’s health. There was no guidance about how staff should recognise if the person became unwell due to constipation or what preventative actions should be taken to reduce the risk of constipation. This did not demonstrate joined up working between the service or other health professionals was effective.

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. The provider did not maintain any robust oversight of the service or peoples’ individual needs. When people had become unwell, improving their care and support was not well planned or monitored which meant outcomes for people did not improve. For example, action in response to the safe management of people becoming dehydrated or constipated were ineffective. Although a person had become very unwell and had been admitted to hospital due to this, the way this continued to be managed and monitored for them and other people was not safe.

The provider had completed some assessment around people’s capacity and had applied for deprivation of liberty safeguards (DoLs) when people lacking capacity were restricted. However, people were not always involved or considered in terms of consenting to the care and treatment they received.

Some staff did not have a good understanding about how people, although lacking capacity, should be consulted with and encouraged to consent as much as they were able, to promote their dignity and choice. For example, staff were speaking about people in a personal way in the communal areas of the service. They were talking about how people looked, what they liked, their strengths and weaknesses. They were talking about people in front of them but not directly involving the person and other people were present in the communal areas. Some of the comments being made by staff could have been offensive to the people they were speaking about and there was no evidence staff had sought consent from the person to speak in this way about them or in front of other people.

For example, staff were talking about a particular person whilst standing directly behind them. They were talking about the person’s age, hair and other personal details. The person was unable to hear so could not participate if they wanted to. One staff member then touched the person’s hair without asking them if they were happy with this. Another staff member commented that the person did not like their hair being touched.