Alexandra Nursing Home - Poulton-le-Fylde

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 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 assessed needs were recorded correctly and updated when required in their care plans.

Where appropriate, families and other stakeholders were involved in the assessment of people’s needs and reviews. Nevertheless, improvements were required to some care plans and risk assessments to ensure they included all of people’s current health needs and risks and clearly guided staff how to support people when they became distressed. We noted 1 care plan held contradictory information; a second care plan held the wrong support information. We shared these concerns with the registered manager who spoke with the authors of the care plans and updated the care plans themselves.

Management understood the current legislation, and had knowledge of best practice, but did not consistently embed this in their service.

Some records did not always include all required information. For people who had diabetes staff did not record what food and how much was consumed. When staff were required to apply patches on people’s skin to deliver medication, this was not done in line with specialist recommendations. This meant the provider could not be assured the person’s care and treatment was effective. The registered manager spoke with staff regarding the application of patches and the need for comprehensive documentation.

Staff were not always recording when thickened fluids were being given to people at risk of choking and aspiration so we could not be assured that these were being managed safely. All the food was freshly prepared in the kitchen. People who were able to express a preference could choose when and where to eat. There was a set menu each day, however the chef regularly prepared people’s favourite meals which weren’t on the menu. The chef told us, “It’s like a restaurant here. The owner is very good at providing what is needed here.”

Feedback from people included, “The food is good, and the choice is good. There is always plenty to eat and I can have a drink whenever I want.” And, “No problem at all with the food. The meals are on time and if you don’t want anything they will sort something else out for you.”

The provider worked well across teams and services to support people. They shared people’s assessment of needs when they moved between different services.

While a visiting health professional told us they found staff were receptive to feedback and will take on board suggestions for improvement. They found documentation had improved, and it is now easier to evidence if a person needed more support, as record keeping was completed in more detail.

Staff used handheld electronic tablets to record daily tasks and diary notes. It meant they could access the information they needed to understand people’s needs, plan their care treatment and support, and share information with health professionals as required.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Management and staff worked with relatives and healthcare professionals to ensure people had access to healthcare. Health professionals such as district nurses, therapists and advocates visited regularly to review people’s health needs.

Staff had good knowledge of relevant health care concerns, how to identify them in the people they supported and how to respond. They knew when people’s mood deteriorated and what strategies to use to make them happier. We observed staff improve someone’s wellbeing by crocheting with them and discussing clothes the person had made for their children in the past. One person was presented with a toy bear, which eased their anxiety and made them happy. When someone refused a meal and drink, 3 different staff took turns to gently encourage them to eat and drink.

The provider did not always consistently monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or that they metboth clinical expectations and the expectations of people themselves.

Daily records did not always record comprehensive information related to people’s distressed behaviours. Records to manage people’s skin integrity and wound care were not consistently completed. This meant people were at risk of not having their health needs met and made the evaluation of care delivered difficult. The registered manager and nominated individual were aware of poor record keeping and were seeking to drive improvement through additional training and supervisions.

The registered manager and community managers completed announced and unannounced visits out of hours to monitor the support delivered, share expectations of staff and took action to drive improvements.

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

The registered manager worked in partnership with people’s advocates and representatives in line with The Mental Capacity Act 2005 (MCA). Staff completed training in MCA and understood the concept of consent. We observed staff gain consent from people before completing any tasks. We saw consent for care and treatment was obtained in people’s care plans and records. The provider made applications to the local authority if people were at risk of being deprived of their liberty.