The Churchley Rest Home Limited

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 requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of legal regulation in relation to consent. The provider had not always sought consent from people or consent had not always been recorded. Mental Capacity Assessments were out of date and not decision specific. Deprivation of Safeguarding Liberty had not been considered and in some cases they were required.

This service scored 58 (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 were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Care plans were in the process of being transferred to an electronic system. Some information contained in care plans was out of date. Outdated information such as mental capacity assessments could lead to people not receiving the level of support, they needed to keep them safe. They are very understanding of her needs. “[Name] would like a bath every day but is only allowed one twice a week.” Another relative told us, “Yes, we went through all the care for my [relative] at the beginning.”

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. Records showed the use of nationally recognised assessment tools, for example the Malnutrition Universal Screening Tool (MUST) for monitoring people’s weight. People’s nutritional needs were met and dietary adjustments made when required. Staff told us, “We can cater for any diet. We have a vegetarian, and we could cater for a religious diet if we were asked. I get feedback on what people like, and I can see by what is left on the plate.” One person told us, “I do like the food, they always make things I like.”

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. Staff were observed working well together and supporting each other. There were good links with the local GP surgery, who visited the home weekly. One staff member told us, “We have good relationships with the GP and community nurses, and we have a clinical nurse we use a lot.” Relatives told us how staff work well together as a team. One relative told us, "She loves the staff. They are fantastic and she has more connection with them than with the residents, but they are so busy." Another resident told us, "The staff have been lovely, fantastic and welcoming. They have helped us through a very difficult time. It is a lovely home.”

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 registered manager gave us an example of how one person was not enjoying their food. They monitored this, and found it was due to health reasons, they told us how they trialled alternative dietary options. A staff member told us, “I want people to enjoy their food and be healthy.” A relative told us, “They do encourage [my relative] to help herself and to eat well.”

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. The registered manager told us how they complete fluid charts on the new electronic care record system and were able to monitor people’s fluid intake and how this supports a more efficient handover to the GP and community nurses. Where appropriate referrals were made to the Speech and Language Team (SaLT). One relative told us, “They contact her GP straight away if she is unwell.” Another relative told us, “They are quick off the mark if she needs to see a doctor. She is registered with a local GP.”

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 MCA 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 make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We saw that people’s Mental Capacity Assessments had expired. Following these findings, the management team had sought guidance and support from the local authority to ensure MCA’s will be updated appropriately. This will ensure staff feel confident and people receive the support they need. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). DoLS had not been applied for, when necessary, the management team, had now requested support with DoLS referrals. While staff demonstrated an understanding of how to support people in making their own decisions, further training and guidance was needed to ensure all staff had a thorough understanding of MCA and DoLS. Whilst the people we spoke with told us staff sought their consent at the point of care delivery, we saw that formal consent was not always in place or recorded in people’s care plans. People living at the home had not been appropriately assessed under DoLS, this could pose potential risk that some people were deprived of their liberty unlawfully, or they might not be safe to leave the home without the necessary support. One staff member told us, "Some people are capable to make decisions, some can't, and you have to act in their best interest."