Archived: Hilbre Manor EMI 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 – 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 to person centred care. People or their relatives were not involved in the planning of how their care and support was provided. Outcomes for people were not always documented or reviewed.

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 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.Care plans were not always in place to support people safely or contained contradictory information. We identified one person’s care plan which stated they required 4 hourly repositioning to prevent pressure areas developing, however within the same care plan it stated they required 2 hourly repositioning. Some care needs were not assessed, for example we identified a person who was diabetic had no care plan or risk assessment in place to guide staff on how best to support them or the signs and symptoms to look out for if blood sugar levels changed and actions to take. We were not assured that people were involved in their care plans. There was no evidence within care plans to demonstrate that people had been consulted about their care and support. One relative told us, “I have never looked at a care plan, but I know they [person] have one” When people’s needs changed, these were often not updated within the care plan. We discussed our concerns with the registered manager who informed us they were moving onto another electronic system which would make recording easier.

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. The processes in place to provide a good learning culture were not effective. We did not see evidence of regular supervision for staff to ensure positive feedback was received and any shared learning provided

The provider did not always work well across teams and services to support people. The provider organised daily meetings with management from Hilbre Manor and their other registered services. However, there was not always a representative from each service at these meetings, and it was not clear on how the information shared in these meetings was cascaded to all staff. There was no effective communication system in place. For example, handover records had limited information and only recorded whether a person had, had a good day or night. Staff meetings that did take place were not frequent. Care plans in place did not ensure people’s needs and wishes could be shared across different services if required.

The provider did not always support people to manage their health and wellbeing, and promote 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. The home had recently employed an activity coordinator, but their role did not cover each day in the week meaning people had no access to activities on some days. Staff would support activities when they were able to however, due to people’s needs and the staffing levels, this was not always achievable. Peoples’ care records did not evidence they had been involved in regularly reviewing their health and wellbeing needs where appropriate and necessary. Because of this we could not be assured people were encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing. There was no signage within the home to orient people to promote their independence.

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. The processes in place to provide a good learning culture were not effective. We did not see evidence of regular supervision for staff to ensure positive feedback was received and any shared learning provided

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.Where a person lacked capacity to make decisions in relation to their care and support needs, we identified the principles of the Mental Capacity Act had not been adhered to, this included ensuring people were supported to make their own decision. There was no evidence to demonstrate alternative methods of communication had been considered. When restrictions were implemented, the service did not ensure they involved the right people in the process to ensure decisions were made in the person’s best interest. For some people restrictions were implemented without evidence of a Mental Capacity Assessment or best interest decision. We reviewed one person’s mental capacity assessment and best interest decision whereby the service provider was the only one involved in the decision-making process.