Inglefield Nursing & Residential 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.

The provider was in breach of regulation in relation to good governance. People received care that met their needs, and staff worked effectively with health professionals to support wellbeing and independence. However, inconsistencies were identified in consent to care, care planning and the use of monitoring tools, staff knowledge and day-to-day practice supported effective care delivery.

This service scored 63 (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 ensure people’s care and treatment were effective because care plans did not consistently reflect people’s current needs. Staff completed assessments; however, inaccuracies and inconsistencies in care planning limited assurance that care delivery was always guided by up-to-date and reliable information.

Records contained contradictory or misleading information. For example, 1 person’s care plan stated they were independent when using the toilet, while another document recorded, they required staff support. In another instance, a person’s care plan referred to the use of stimulant or laxative medicines and creams to manage constipation and maintain skin integrity, but these medicines were not prescribed to them. These issues reduced assurance that care plans accurately reflected assessed needs and prescribed treatment.

Despite these inconsistencies, assessments were generally detailed and person centred. They considered people’s health, care, wellbeing, and communication needs. Care plans were reviewed regularly, and records showed that people and their relatives were involved in updates. Staff demonstrated a good understanding of people’s needs and preferences, which supported care delivery in practice.

The registered manager recognised the need to improve the accuracy of care planning. Care planning training workbooks had been introduced prior to inspection and were being evaluated by the compliance lead to support staff in assessing needs accurately and updating care plans appropriately.

The provider planned and delivered care and treatment in collaboration with people, focusing on what was important to them. Staff delivered care in line with legislation, professional standards, and evidence-based good practice.

Nationally recognised assessment tools were used to monitor health and guide interventions. Staff applied evidence-based tools such as the Malnutrition Universal Screening Tool (MUST) and Waterlow pressure area risk assessments to inform care. Staff demonstrated awareness of evidence-based approaches and applied them in practice to support safe and effective care.

People received care and treatment in line with professional standards. For example, food and fluids were prepared according to International Dysphagia Diet Standardisation Initiative (IDDSI) levels, ensuring people received texture-modified diets safely. A person told us, “I have a throat, swallowing problem… they know what I can have according to the hospital.”

Care and treatment were largely delivered in line with recognised guidance. Assessments were carried out regularly, interventions were planned to meet identified needs, and staff demonstrated understanding of how to implement guidance in everyday care routines, including nutrition, hydration, and pressure area management. This supported positive outcomes and safety for people.

The provider worked well across teams and services to support people and reduce the need for them to repeat information. Assessments of needs were shared when people moved between services, ensuring continuity of care.

Communication between staff was clear and structured. Shift handovers highlighted changes in condition, planned interventions, and individual needs consistently. Information was also shared in nursing meetings and cascaded to care staff, helping all team members stay informed.

Collaboration extended to external services to support timely care. Referrals to healthcare professionals were made promptly, and personalised hospital packs contained essential medical information, care preferences, and risk alerts. Staff demonstrated effective cooperation, such as using a wound management reference board to share best practice, supporting coordinated care and positive outcomes. A staff member said, “Everyone works together as a team… staff feel comfortable to speak and support each other.”

People and relatives confirmed effective teamwork and collaboration. Relatives described regular updates from clinical practitioners, and people told us they received coordinated care during visits or emergencies. Strong internal and external collaboration ensured needs were met safely, promptly, and in line with individual preferences.

The provider supported people to manage their health and wellbeing, helping them maximise independence, choice, and control. Staff encouraged healthier lifestyles and worked to reduce people’s future needs for care and support where possible.

Staff demonstrated flexibility and dedication in promoting physical activity and overall wellbeing. A person told us, “My walking went down, they gave up their break times sometimes to take me out for a walk.” Staff consistently responded to people’s individual needs, ensuring care supported recovery, health maintenance, and overall wellbeing.

People were supported to make choices about their daily routines, diet, and exercise. Staff encouraged participation in activities that promoted both physical and social wellbeing, helping people maintain independence and quality of life. Staff engagement ensured people felt safe, cared for, and supported to maintain their health.

Relatives highlighted positive outcomes from staff support. A relative said, “The staff have done sterling work to help him gradually sit up.” Another said, “At one point, doctors thought he would only ever lie flat in bed, but the staff encouraged him to progress.” A third relative told us, “She had been catheterised many years ago, but the staff worked with her to remove it and cope without one.” These examples demonstrated the impact of personalised support on people’s health and wellbeing.

The provider did not always routinely monitor people’s care and treatment to support continuous improvement. Staff implemented systems to monitor outcomes; however, these did not consistently produce positive results or align with clinical expectations and people’s individual needs.

Pain management assessments were not always used to guide care effectively. Abbey Pain Scale assessments were completed monthly as part of the review process, but staff did not consistently use this tool to assess pain relief requirements for people unable to express pain verbally. This reduced assurance that pain was always assessed and managed appropriately.

Monitoring of vital signs using National Early Warning Score 2 (NEWS2) assessments was inconsistent. Assessments were completed monthly or when people were unwell, but where scores of 1 or 2 were recorded, follow-up assessments were not always carried out. Staff explained that these low scores were expected baseline values for some people; however, this was not consistently documented in care plans, reducing assurance that expected observations were clearly understood.

Managers were aware of these gaps and had started taking action. Team meetings included discussions on improving the use of assessment tools and documentation. Staff received support from the leadership team to implement changes aimed at strengthening monitoring processes.

While systems were in place to monitor care outcomes, inconsistencies in assessment and documentation limited assurance that monitoring consistently supported effective care. People’s care was generally delivered safely, but improvements were required to ensure that outcomes were reliably measured and acted on.

The provider did not always ensure people were fully informed about their rights or that these rights were consistently respected. Staff followed consent processes; however, gaps in documentation limited assurance that care and treatment always reflected people’s informed choices.

The provider did not follow the required procedures in obtaining consent to CCTV. Cameras were installed outside the building, and although the provider indicated their use was implied in contracts, staff had not obtained specific consent forms from people. People told us they were not fully aware of how surveillance was being used.

Some consent forms for care and treatment were signed by staff on behalf of people with dexterity difficulties, and it was not always clear who had signed consent forms.

Where possible, legal consent was obtained. Staff completed Mental Capacity Act (MCA) assessments and best interest decisions when required, and authorised representatives, such as lasting power of attorney (LPA) holders, signed on behalf of people when necessary. Consent for care, assessments, medicines administration, and access to personal information was generally documented appropriately.

People confirmed staff respected their choices and autonomy. A person told us, “You’re free to choose, you’re not kept in bed all day but if you want to stay in bed all day you can.” Another person said, “Strictly I should have my legs up half a day… I’ve decided quality of life is more important and they respect your wishes.” While staff demonstrated respect for people’s decisions, inconsistencies in documentation limited assurance that consent was always fully informed and recorded. The provider was taking steps to address these shortfalls.