Ebenezer Residential Care 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

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 changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation not routinely working within the principles of the Mental Capacity Act 2005.

This service scored 50 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

We found that care plans were not updated as people’s needs changed. For example, daily records for 1 person indicated care and support was not consistently given and equipment they needed to help maintain their hygiene was not clearly written in their care plan.

Whilst information about people’s health was recorded in their initial assessment, this information was not within their care plan. For example, one person’s pre assessment form confirmed they had diabetes. This information was not recorded in this person’s care plan, so staff were not aware of it. This meant people’s health needs were not always being fully met by the provider.

The provider did not make referral to appropriate healthcare professionals such as SALT when they identified people at risk of choking.

We spoke to relatives and they confirmed with us they were not being involved in care review meetings. A relative told us, “We were not offered or invited to participate in the care plan review meetings. However, staff do tell us about my [relative]’s health and well being. If [my relative] tells me about a concern, I pick up my phone and speak to the registered manager or nominated person.” Another relative told us, “Not in so much details”, when we asked them if they were involved in care review meetings.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

The provider did not always ensure people received care and support based on the latest good practice and relevant guidance.

We found people living with diabetes did not have risk assessments in place. This meant staff may be unaware of risks like low blood sugar, affecting safe, evidence-based care.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

We found people’s care records were not kept up to date and people were not referred to healthcare professionals when their needs changed. For example, daily care records of a person were not matching with the information stated in their care plan. Referrals to healthcare professionals such as SALT were not made when people’s needs changed.

The care plans we reviewed clearly highlighted the support people required accessing healthcare services. Staff supported people to attend their healthcare appointments.

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. A relative told us, “Staff do discuss concerns related to my [relative] health and well being with me”.

Staff assessed, monitored and recorded information about people’s daily routine including what they had for breakfast, lunch and dinner, activities, and support provided to maintain independence, choice and control over their health and welling.

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.

Staff did not always recorded concerns about people’s health and wellbeing. In some cases, follow up action was not clear when concerns had been identified.

The provider did not keep a track of people’s daily routines effectively. For example, the provider did not record people’s daily routines activities during the nighttime. This meant if a monitoring would be required for a person following an incident or healthcare issues, information would not be available to the registered manager for analysis and to decide further action.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

We found the service was not routinely working within the principles of the Mental Capacity Act 2005. The provider requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the capacity to consent to these. Decisions about people’s care were made in their best interests and for their safety. We saw the Deprivation of Liberty Safeguards (DoLS) was authorised for a person and conditions were placed by the funding local authority. The provider did not complete mental capacity assessments and best interest decisions for this person in relation to day-to-day care and support, locked doors, feeding and hydration, 24-hour monitoring, one to one supervision in the community, personal hygiene, andmedicines management for one person. This meant the provider did not adhere to the conditions and the person’s needs were not being fully met.

Another care plan we reviewed stated a DoLs was authorised for the person correctly. However, we found no records whereby people, their relatives and healthcare professionals were involved in making best interest decisions for this person.

The best interest meetings under the Mental Capacity Act 2005 are a formal, multidisciplinary meeting to make decisions for someone lacking capacity. Records showed that, in this case, provider did not organise any such meetings.

The provider also could not demonstrate to us how to they monitored DoLS conditions.