Fewcott House Nursing 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 79 (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 admission, care records highlighted key information such as risks and communication preferences. Support plans were clear, detailed, and person-centred, outlining how staff should support people to meet their needs. Where required, healthcare professionals were involved in assessing needs and providing guidance in line with best practice, which led to good outcomes for people.

If the provider could no longer meet a person’s needs, staff worked with external professionals to identify a more suitable placement.

One professional told us, “Patients are looked out for and [management are] very aware of NICE [National Institute for Health and Care Excellence] guidelines. [They] go beyond what is expected.”

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 received effective care and support by a staff team that received regular training and had a good understanding of people’s needs. Staff demonstrated a caring approach and understood what mattered most to people, which positively influenced the culture within the service. This meant people’s choices, experiences and expectations were promoted, helping to enhance their quality of life.

People were supported to have enough to eat and drink to maintain their health and well‑being. Staff knew people’s food preferences well and explained how they encouraged and supported individuals to be involved in choosing, planning, and preparing their meals. People made daily decisions about what they ate and drank and when.

We were told one person required a Halal diet and this was catered for. We observed staff demonstrating a good awareness of dietary needs and a person-centred approach during lunch service.

One relative said, “[Person] had lost 10kg in their last home in 3 months and we didn’t know. This place [Fewcott House] picked this up, [provided] fortified diets and monitoring. [They are] respectful and careful with my relative.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The service worked with a range of professionals, which included the local GP surgery, district nursing team, commissioners and the local authority safeguarding team. Professional advice was sought promptly when needed, with guidance from healthcare professionals recorded. Professionals gave positive feedback regarding the working relationship they had with the service.

Staff worked well together to share information and plan care. Staff told us they had easy access to care plans, which helped them provide consistent support. Staff said communication within the team was “very good” and information about people’s needs was shared promptly. One staff member said, “When new people move in, we are given a proper description of what their needs are, such as the person’s mobility, food and fluid needs. The management team share the pre-admission assessment with us. When the resident moves in, we get another update at the handover so if there are any changes, we are updated with the information.”

One professional told us, “[I have] worked with them for years, we have a good working relationship. They contact me in a timely way. If anything, they might do too much and don’t make unnecessary referrals. Decline in [a person’s] cognition can happen quickly. They know their limitations. No judgements. Genuine caring side”

Another professional said, “I recall the family stating [deputy manager] had worked hard to include their voice in care plans and delivery. I felt from reading the care plans and speaking to staff in the home, the care provided was person centred and individualised to the person’s needs. It also appears to represent the least restrictive option, [Deputy manager] showed a detailed understanding of the individual needs and medical conditions during conversations.”

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 provider had a work/engagement and fulfilment policy for younger people to ensure every younger adult resident at Fewcott House is supported to lead a life defined by their own aspirations, including access to work, education, and meaningful engagement.

The provider made sure referrals to appropriate health services were made quickly when people’s needs changed and acted swiftly on recommendations. When a person with mobility limitations needed a dentist, the provider arranged for one to visit the home.

People’s dietary needs were understood and effectively met, including specialist diets recommended to support their health or medical conditions.

One relative told us, “They managed to get [person] to the lounge a few times to take part in musical activities which was difficult as [they were] bed bound and felt faint if [they] stood up. It took three staff and a hoist, but they really made the effort and it was great for [persons] mental health. They were really good at trying to get [person] to eat and drink wholesome food.” This meant people were encouraged and supported to live a healthy life.

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.

Systems to monitor and improve outcomes were effective. The provider had processes in place to ensure people’s care and support were continuously monitored and reviewed to promote good outcomes. People received individualised care that was flexible and responsive to their needs, delivered by staff who knew them well.

One relative told us, “ [Person’s] physical health improved initially with better care than could be provided at home.”

Staff told us each person is weighed monthly and this was evidenced within their care plans. The registered manager told us weight is monitored as an indicator of overall health. Staff also told us, “There are more than 20 people who can eat independently. We offer support to those who need help. They are given plenty of fluids throughout the day. We have measured beakers – we record on devices.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However more work was needed to ensure documentation reflected best practice guidance.

The provider had policies and procedures in place to support people in understanding their rights. Records showed training had been provided in safeguarding adults, the Mental Capacity Act 2005 (MCA), and the Deprivation of Liberty Safeguards (DoLS). The registered manager and staff spoke about the importance of obtaining consent and applying the principles of the MCA.

However, some mental capacity and best‑interests documents lacked details of which specific decisions were being assessed and were not always completed in line with the principles of the MCA. The deputy manager acknowledged updates were needed to better evidence person‑centred decision‑making. While no one had been placed at a disadvantage, we recommended all relevant documentation is reviewed to ensure decision‑making is applied and recorded consistently. We received reassurances these documents will be corrected.

Where a person had a DNACPR (Do Not Attempt Cardio Pulmonary Resuscitation) agreement in place, which had been discussed and agreed with the person and next of kin, it was clearly documented in the care plan and staff stated they were aware of where to find the information.