Stanley House

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 people’s consent and decision making under the Mental Capacity Act 2005 (MCA).

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 always make sure people’s care and treatment was effective because they did not routinely check and discuss people’s health, care, wellbeing and communication needs with them.

People and relatives told us they had been involved in discussing their care needs when they moved to live at Stanley House however, most told us they had not had any further involvement. One relative said, “I did all the admission paperwork but haven’t seen anything since about planning.”

We found one person who had been assessed as being at high risk of falls, however they did not have a falls care plan in place. Another person’s care plan stated they had capacity to understand and make decisions for all areas of their care however, this had not been updated to reflect how this had now changed. For another person requiring pressure care , their care plan included out of date comments that their pressure sores were healed and their skin intact. When people had pressure sores or wounds, there were not specific wound care plans in place that detailed people’s specific wound dressing requirements and routines. This placed people at risk of inconsistent care as their care plans were not always up to date or accurate.

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

People told us they were satisfied with their meals and drinks and that these met their needs and preferences. One person told us, “The menu is varied every day and very good choices. It all looks fresh and the Sunday roast is very nice.”

However, records to show what people had been offered to eat and drink had not been consistently completed and the records contained multiple gaps. They also recorded that people who required a specific modified texture diet to reduce the risks of choking had not consistently received this. The registered manager told us people had received enough to eat and drink and had received their correct modified texture diet, but this had not been recorded accurately. They told us they would make changes to help improve the accuracy of people’s food and fluid records. However, this meant that at the time of our assessment, the provider could not reliably demonstrate what people had eaten and drank. This is important as this information should be used to inform the monitoring of people’s health and care and treatment decisions.

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.

Records showed staff had received updates on any new learning identified or improvements made. For example, from using the new electronic care planning system or from improvements made to the completion of accident reporting.

Care staff were confident on what issues they needed to report to the nursing team or to managers. One care staff told us, “It’s lovely to work here, we come together as a team, we communicate well and we try and maintain a lovely environment for everyone.”

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 told us how they supported people to increase their independence. One staff member told us, “[Name of person] was reluctant to use a Zimmer frame, and since they have been here, we have supported them to use it to walk to the bathroom and their confidence and ability has got much better with that encouragement.”

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, or that they met both clinical expectations and the expectations of people themselves.

Records of people’s food and fluid intake viewed during this assessment were not accurate or complete. Therefore, the provider was not able to demonstrate how they would be able to quickly identify changes in people’s food and fluid intake and take action to maintain their safety and wellbeing and reduce risks to them.

Records showed one person had lost 3.5kg of weight in the last month and their weight placed them at high risk of malnutrition. When we asked if a referral had been made for dietary advice, the registered manager told us the last weight recorded for this person had been either an incorrect reading or a recording error and they had not lost the amount of weight that had been recorded. This meant that the provider had not taken action to check the person’s weight was correct or sought further advice on their weight loss prior to our inspection.

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

The provider used CCTV to record activity in corridors, and they said information about this was included in the staff handbook and in the terms and conditions of the contract for people living at the home. However, this did not demonstrate that people had been able to discuss this, and what their views were, including for one person whose relative told us they had chosen to opt out of having their photograph used for certain aspects of their life at Stanley House. Additionally, this did not demonstrate how people who could not understand and process the information on the use of CCTV had their rights upheld by the application of the MCA and DoLS processes.

People had capacity assessments and best interests’ decision-making records for other aspects of their care. However, for one person, these were incorrect and stated they were able to understand and process information relating to decisions about their care. However, their needs had changed, and this was no longer accurate.