Cheriton Care Home

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.

The service was in breach of legal regulation in relation to consent.

This service scored 50 (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.

The service had a pre-admission and admission policy. It outlined that a suitably qualified competent staff member would complete the pre-admission assessment document to evidence the assessed area of need. It indicated that for emergency admissions the pre -assessment will be completed within 48 hours and audited by the registered manager within 72 hours. In 2 assessments viewed we found the background information was not completed and where a person required an International Dysphagia Diet Standardisation Initiative (IDDSI) diet there was no reference to the provider assuring themselves whether a Speech and Language Therapy Assessment (SALT) had been completed or was required. 1 person’s pre assessment made no reference to whether they were prescribed any medicines. In both assessments the section to confirm if the service can meet their needs was not completed and for the emergency admission there was no update or audit of the pre assessment document to ensure it was fully completed. During feedback with the provider, they assured us they would have other background information on people that was not referred to in the pre assessment document including the initial referral to them. This was not reflected in their own assessment in line with their own policy.

The provider did not always plan and deliver people’s care and treatment with them. They did not always follow relevant legislation and current evidence-based good practise and standards.

Some people who used the service were diabetic. Whilst the provider assured us people with diabetes have diabetic cakes and the option of low sugar and sugar free puddings, their records did not indicate that these options provided to them were low sugar or sugar free.

2 people who use the service were on an International Dysphagia Diet Standardisation Initiative (IDDSI) diet. The provider told us that they understood the national IDDSI framework and appropriate foods. However, care records showed that people had been offered and eaten food such as toast, sandwiches, and marshmallows which is not within the requirements of this diet. This meant that people were not supported to manage their nutritional needs, and the service was not consistently working to relevant guidance.

We observed food was offered throughout the day, and drink was always placed in people’s reach. The service had a cook and people had access to regular snacks.

The provider did not always work well across teams and services to support people.

The provider had systems in place to ensure information was shared with team members to ensure people’s needs were met. These included daily handovers and ‘resident of the day’. However, the handover records viewed did not show that changes about people noted on the 2 days of the site visit were recorded and handed over to staff. The ‘resident of the day’ process did not highlight and result in changes to care plans and risk assessments where this was required. During feedback to the provider the registered manager assured us they had identified this, and they were providing training to staff on improving handovers and ‘resident of the day’.

The team meeting minutes did not include discussion about people and therefore with the handovers and resident of the day process not being effective there was no opportunity to discuss people’s care to promote a team approach to care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service had a visiting GP which enabled them to ensure changes in people’s health was monitored and managed. Records were kept of engagement with health professionals and actions agreed. The service used Telemeds which is a service available to care homes and provides virtual consultations with GPs and healthcare professionals via secure video and phone platforms to promote timely access to specialist advice and escalation to health professionals as required.

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

Systems were in place for senior carers to monitor and report on the care provided to people. However, the senior care records viewed did not evidence that they were identifying when personal care, oral care and repositioning of people had not taken place. This did not promote positive outcomes for people.

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

Mental capacity assessments for day-to-day decisions were not always in place or adequately assessed, and best interests' decisions did not consider peoples’ feelings, beliefs and values. This meant that people were not safeguarded from harm and were treated in an undignified way.

Staff responsible for completing assessments were trained in the Mental Capacity Act 2005. However, they failed to complete the required decision specific mental capacity assessments and best interest decision meeting records for people who required them. The provider assured us management and senior staff attended Mental Capacity Act and Deprivation of Liberty Safeguards training provided by the local authority.

People who lacked capacity had no mental capacity assessments or best interest decision records for sensor mats which were in use and specialist diets which their care plan outlined they required. As a result, we saw a person had food not in line with their religious needs and wishes.

People had recently had flu jabs. The service had sought consent from relatives but there was no mental capacity assessments or best interest decisions recorded to evidence the decision was agreed in line with the principles of the Mental Capacity Act 2005 for people who lacked capacity.