Holme Lea

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

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 62 (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.

A relative told us, “We sat down with the manager when [family member] first went in and discussed her care. I am not aware that we have done so since then.” Another relative told us that they had never seen their care plans. The care planning system did not have all ongoing assessments in place for people at the time of our visit but work was ongoing to address this.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’s care and treatment was not always informed by the most current legislation and evidence-based good practice and standards.

Care plans were not always person centred and lacked detail; it was unclear if family or a representative had been included in decisions where the person could not make the decision for themselves.

Daily records did not clearly show how people had been supported with repositioning or personal care; this could cause confusion and pose a potential risk to the quality and safety of care provided.

The provider worked well across teams and services to support people. Doctors reviewed people’s health needs on a weekly visit. Staff worked with a range of other health providers including speech and language therapy team, dieticians, physiotherapists, chiropodists and the continence team.

Daily flash meeting where any needs of residents were discussed ensured information was shared, and there was a good interaction between the staff and the manager.

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.

We saw that staff communicated well with people and worked effectively as a team. One staff member told us they all worked well together and supported each other.

The registered manager informed us they had worked in building a good relationship with the district nursing team and a weekly meeting was held via teams between them and the leader of the district nurses to discuss residents’ needs and any further referrals that may be needed. All residents had an annual eye test.

A relative told us, “They will call up the GP when needed. Sometimes this is an out-of-hours doctor or a nurse.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

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

Some care plans lacked detail; however, work was ongoing to ensure risk assessments were in place. The chef was actively involved in improving nutrition for people and nutritional care plans were being updated. Food generally looked appetising. A relative told us, “I saw some afternoon snacks of crackers with pepperoni and cheese being given out in the lounge when I was there. They do get a choice of food.”

Records we looked at in relation to nutrition and fluids did not always contain information such as particular food preferences, especially where dietitian advice was in place and it was not always evident that this guidance was being followed in the daily records.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Consent was generally obtained before support was provided. There were limited records in relation to written consent for people who had capacity or where local power of attorney was in place on the electronic care planning system. However, the manager and area manager told us about the system they had in place whilst this information was being uploaded to the new system.