The Old Rectory 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 62 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed before they moved into the home and records confirmed this. The registered manager shared their commitment for a safe transition. They told us, “I always try to assess them myself. When I know we've got a new resident coming, I won't leave the building. I'll ensure they have basic care plan, medication chart, and an evacuation plan.”

People had individual plans of care which were regularly reviewed to ensure they continued to meet people’s needs. Records showed the registered manager involved relatives through quarterly reviews.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People were encouraged to have enough to eat and drink. Staff offered people a range of choices based on their individual preferences. One person told us, “The food here is lovely and we have plenty to eat and drink.” The cook was observed spending time with people and asking them what they would like to eat for lunch . Information regarding people’s dietary needs was documented in their care plans

The provider used recognised tools to assess and identify risks to providing people’s care and support, including to assess the risk of skin damage and falls.

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.

Health professionals shared positive feedback about communication from the team. A GP told us they receive regular emails from the registered manager with updates on people, and a district nurse said, “If they [staff] see something they call us in which is great.”

Staff worked well together. One staff member told us, “We have a really good team. If you need anything someone is always there to help and that even extends to outside work.” Staff used a designated ‘significant folder,’ which contained essential updates on people, enabling staff to provide safe 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.

People were supported to receive treatment from other services when required. One person told us, “I see the chiropodist, and the barber.” Another person told us they see the GP on a regular basis.

Staff understood the importance of early detection of health changes through observation and communication. One staff member said, “Because we’re not a huge home you really get to know each resident and pick up very quickly if they are not right. We talk to them to understand what’s wrong and then we can get help.”

Records documented when referrals had been made for people to other services such as the continence team and memory clinic.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Relatives were confident their family members’ health was monitored. One relative told us “The staff would contact us if concerned of anything to do with [the person’s] health.”

Processes were in place to monitor the care and support people received. Records confirmed people’s weight was monitored regularly and their skin integrity was observed closely, with any concerns documented and reported to the appropriate professional.

Care records included information from the NHS on people’s individual health conditions to provide staff with the knowledge to better support people and help improve health outcomes.

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

Whilst people’s capacity to make their own decisions had been considered, capacity assessments reviewed on inspection, contained little to no detail on how individuals were supported to understand the decision in question. Capacity assessments must be decision-specific to ensure they accurately reflect the person’s ability to understand, weigh, and make that decision at that time. We found the assessments were generic and assessed several decisions at one time.

Further inconsistencies were found in the information provided. Staff reported that some people lacked capacity to make certain decisions, despite assessments stating they had capacity. Information in their care records was also contradictory. This meant people were at risk of not having their rights upheld and decisions respected, leading to inappropriate care or restrictions on them. Equally, a person wrongly assessed as having capacity to make certain decisions would lack safeguards and support, leaving them vulnerable to making poor decisions they may not be able to understand or manage. The registered manager shared a commitment following our feedback to improve procedures around assessing capacity.