Applecroft Residential 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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 usually assessed before they moved to the service. Staff obtained information from other professionals and commissioners to ensure they could safely meet people’s needs. Staff used various recognised assessment and monitoring tools to help plan, review and adjust people’s care plans to meet their needs.

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

Staff used assessments to form the basis of people’s care plans, which were reviewed monthly. The registered manager had focused on ensuring all relevant information was transferred and included to a new electronica care plan system. Overall, these contained individualised information about people’s care and support needs. However, some care plans did not have up-to-date information and would benefit from some further information to help guide staff. For example, guidance about supporting a person’s health needs or how best to support a person when they displayed distressed behaviours.

The provider used a company called Appetito to provide ready-made dishes including textured modified meals. People were generally positive about the food on offer. Comments included, “The food is nice, you get a choice.” Systems were in place to monitor and respond to any nutritional concerns.

Where a person required thickened drinks to help with swallowing difficulties, information was included in their care plan. However, this was not sufficiently detailed, as it did not include how staff should administer prescribed liquid medicines. Records also suggested that on some occasions staff had not prepared the person’s drinks to the correct consistency. The registered manager believed this was more likely to be a recording error, as staff understood the person’s requirements. However, the provider’s oversight had not identified this issue.

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.

Staff worked closely with the local GP practice. A GP undertook a weekly visit and staff worked in partnership to review and respond to people’s health needs. They had recently invited the district nursing team to join these meetings, to help strengthen communication.

The registered manager worked in partnership with social care professionals to share any concerns or issues they may be experiencing.

Staff told us they worked well together and were kept informed of any changes. They used a communication book and the electronic recording system to share important updates. Regular handover meetings were held.

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.

Staff referred people to various health and social care professionals for advice and support where necessary. For example, staff worked in partnership with mental health teams, district nurses and dietitians. Regular reviews of people’s health needs were undertaken.

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.

Staff undertook monthly reviews of people’s care plans to ensure their needs continued to be met. There was a ‘resident of the day’ system, meaning all aspects of people’s care plans were reviewed. Whilst staff liaised with people and their relatives about changes to their needs on a day-to-day basis, people were not always aware of being involved reviews and records did not demonstrate their views had been discussed. The registered manager told us they would ensure reviews were recorded more robustly in future.

Feedback indicated staff proactively monitored and addressed people’s changing needs. A visiting professional told us, “They are proactive at dealing with any changes or deterioration in people’s needs.” Where people’s needs had changed, staff liaised with social care and other professionals to ensure appropriate actions was taken in response.

The provider did not always tell people about their rights around consent and records did not always demonstrate they respected their rights when delivering care and treatment.

Staff sought consent from people before providing care and support. However, they had not always recorded within the electronic system whether people had consented to their care plan arrangements. The registered manager told us they had been working to address this.

Where people lacked capacity to decide about their care and treatment, the registered manager ensured Deprivation of Liberty Safeguards (DoLS) applications were made as required and they had oversight of this process.

Staff generally involved people in discussions about their care and support needs. However, where restrictions were placed upon people who lacked the capacity to consent, staff had not always recorded mental capacity assessments and best interest decisions, as required. For example, in relation to the use of bedroom sensors to monitor people’s movements or frequent observational checks. The provider’s oversight system had not identified this gap in practice, and the registered manager told us they would address this.