Liversage Court Residential 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.

Care plans were not always accurate, complete, or up to date, and did not consistently contain sufficient detail about people’s needs, which meant there was a risk care was not always planned or delivered in line with people’s current requirements.

People told us they were involved in discussions about their care at the point of admission; however, this involvement was not consistently maintained, and people were not always regularly involved in reviewing or updating their care plans. A person said, “They asked me a lot of questions when I arrived.” A relative said, “We went through the paperwork when [our family member] arrived and knew [they have] a care plan but we’ve not seen the detail. We talk to them in the office occasionally if we need to know anything.” A person said, “I know I’ve a plan on paper, but it’s not been discussed with me.”

Care plans relating to diabetes did not consistently include clear guidance on the signs and symptoms of hypoglycaemia and hyperglycaemia, which meant staff may not have had sufficient information to recognise and respond appropriately to changes in people’s condition. Another person’s care plan referred to requiring regular repositioning which was no longer accurate.

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

We reviewed the care record for a person with a learning disability. Care being provided did not follow current evidence-based good practice and training and care plans required improvement. This was raised with management who have started to take action.

We reviewed the care record for a person with a catheter. Fluid balance records for this person were not consistently completed or accurately maintained for people which meant there was a risk signs of dehydration, blockage or infection may not be identified and responded to promptly. Fluid audits were not taking place.

People were happy with food at the service. A person said, “It’s very nice on the whole. They ask us beforehand what we’d like and they’d do you something different if you needed.” People’s diverse needs were met. We saw a person received vegetarian food and a person said, “The portions are good and they make allowance for my diabetes.”

We observed lunchtime on the first day of our assessment. The mealtime was organised and meals were served promptly, with people receiving appropriate portion sizes and eating well. While staff were available to support people and ensured drinks and assistance were provided, there was limited interaction observed during service, and information about meal choices was not always easily accessible or clearly presented.

People told us they were able to access drinks mainly at mealtimes or during regular tea trolley rounds. However, drinks were not routinely available within people’s bedrooms and there were no visible hydration stations within the service. People said they would need to request drinks if they were thirsty outside of these times, for example one person said, “If you get thirsty, you can ask staff.” Another person told us they bought bottled water to keep in their room overnight.

Staff were confident in referring to other organisations. People received effective monitoring of their health and where concerns were observed, appropriate referrals to healthcare partners were made in a timely way.

A professional commented, ‘[Staff] respond positively to recommendations and are always keen to learn.’

Staff described good communication within the service, that they worked well as a team and that managers were described as approachable.

The provider had systems in place to support people to manage their health and wellbeing to maximise their independence, choice and control, however, they were not fully effective. We identified concerns during this assessment regarding support provided to people regarding their health and wellbeing, including medicines management and diabetes care.

People told us of visits made by external professionals. A relative said, “The hearing lady came in to do a test. [My family member] gets the chiropodist visits and looks forward to [their] weekly hair do.” Another relative said, “An optician has been in to fit [my family member] for glasses.”

Care records showed people were supported with healthy eating. Staff completed training to support people to manage their health and wellbeing.

The provider had systems in place to monitor people’s care and treatment; however, these were not consistently effective in identifying or addressing areas where improvements were required. While some monitoring tools were used to review people’s health and wellbeing, these had not always identified gaps in care delivery identified during the assessment, including inconsistencies in fluid monitoring and care planning.

Although staff worked with external healthcare professionals and responded to emerging concerns, internal processes to evaluate and improve outcomes were not sufficiently robust. Opportunities to identify trends, learn from issues and drive improvement were missed, which meant people were not always assured that care and treatment were being effectively monitored and consistently improved. The provider routinely monitored people’s care and treatment to continuously improve it.

A professional commented, ‘The home is usually quite good at communicating with the Care Home Team or surgery if they have concerns regarding a resident or require advice.’

Mental capacity assessments were completed; however, best interest decisions were not always clearly recorded, which meant there was not always clear evidence that decisions had been made in line with the Mental Capacity Act. A policy was in place, and training was provided but not all relevant staff had completed this.

People’s consent was sought and respected. A person said, “They’re usually ok at asking me before hoisting me or washing, which is good.” Another person said, “The staff don’t just crack on, they involve me first.” We observed staff seeking people’s consent before providing care and support and respecting their decisions.