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 changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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. We saw care plans and risk assessments were reviewed but action was not always taken to update documents when required. People and relatives told us their care plans were not always discussed with them. One person said, "They [staff] don't really discuss my care with me." We spoke with the management team about these concerns, and they told us they would take action to address them.

The management team 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. Staff were aware of people’s specific dietary requirements and how to meet them. One visiting professional said, “I feel the current management is really trying to improve the care of residents at Lower Bowshaw View and I have seen improvements within this. This includes basic care needs being met to maintain appropriate documentation which when requested they can find and tell me, this includes weights, bowel charts, medication updates etc. The current care staff appear to really have the residents’ best interests at the forefront of their role.”

The management team 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. However, whilst there had been some improvement in staff communication, further work was required to ensure senior staff and nurses worked effectively together. The management team were supporting staff to improve communication across teams. Since our last assessment the handover documentation had improved. The management team were in the process of supporting staff to follow up on issues identified as part of the handover meetings to ensure people received the right support in a timely way. The management team had set up a system where they communicated via email to nurses and seniors and held daily flash meeting to suggest how they could support each other. To strengthen communication, visiting professionals were required to sign in at the home and record outcomes before leaving, to ensure their advice was shared with the management and clinical teams.

The management team 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 referred people to other agencies promptly, and there was clear evidence of collaborative working.One visiting professional said, “Initially, the service appeared to struggle with the scrutiny and the volume of work required to improve recording practices. However, in the last couple of months, I have observed a clear improvement, with management more able to action required changes and demonstrate increased organisational oversight.” People and relatives knew a weekly doctor’s ward round took place and felt a doctor would be informed if they needed one. One relative said, "They [staff] did get a doctor for [family member] as their oxygen levels were low. [Family member] was treated and they improved rapidly."

Staff and leaders 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. People’s outcomes were documented in care plans and showed actions taken to ensure these were met. For example, staff had access to information about modified diets to enable them to provide meals at the correct consistency and in line with guidance from visiting professionals such as the speech and language team. The management team held weekly clinical governance meetings to ensure people received the right care and their outcomes were monitored.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Best interest decisions considered people’s wishes, feelings, beliefs and values. They also stated the reason why the person was unable to make the decision, for example diagnosis of dementia. We observed staff interacting with people and found they spoke with people about the task they were about to complete and proceeded when people were comfortable doing so. Staff offered choices in line with people's preferences. One staff member said, “I always respect people’s choices. I always ask what they want. If someone has no capacity to make their own decisions or struggles to decide, I use very simple language, eye contact or gentle prompts to help them.”