Archived: Lower Bowshaw View 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 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.

This service scored 42 (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 not always reviewed to ensure people received the most appropriate care and support. Some staff were slow to identify changes in people’s needs and therefore people’s care plans had not always been reviewed, evaluated or updated to ensure their current needs were being met. For example, 1 person was at risk of developing pressure areas, but their care plan lacked detailed guidance for staff to follow to ensure this risk was mitigated.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. They did not follow legislation and current evidence-based good practice and standards. We found concerns in relation to people’s oral hygiene where care plans did not accurately reflect people’s needs. People told us they enjoyed their meals and always had enough to eat and drink. However, where people were at risk of losing weight, their care plans and daily notes did not always reflect their current needs.

The provider did not always work well across teams and services to support people. Assessments were not always up to date so there was a risk of sharing information which was not current. The current management team told us they had identified poor communication throughout the staff team and had implemented handover sheets to improve this. However, handover sheets we reviewed were not clear and, in some cases, not legible. Flash meetings were in place to ensure heads of departments met and discussed current issues. However, these used to be led by the management team. This responsibility had been passed to senior staff and nurses and since then they had not been completed as frequently. One professional said, “The [nurse] sometimes doesn't seem to know what's going on seemingly as a result of patchy handover between staff.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.Visiting professionals had raised concerns regarding staff not following up on issues after people had been discharged from hospital. The management team had taken action to address these concerns and had implemented an hospital discharge policy. However, this policy needed embedding in to practice.

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. For example, 1 person had stopped going out because they were no longer confident to use a taxi. The person was low in mood, but staff and leaders had not been pro-active to facilitate a more positive outcome. Another person spent the day in their room and enjoyed watching the television. However, they could not see the television as they had been without spectacles for quite some time. We spoke with the management team regarding these concerns, and they told us they had taken action to address them.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Staff lacked understanding about the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Acts 2005 (MCA). Some work had commenced in regard to mental capacity assessments and best interest decisions were in place where people lacked capacity to consent. We observed staff obtaining consent prior to them completing a task.