Shaftesbury New Court Place

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 the last inspection we rated this key question as good. At this inspection this key question has remained 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed before moving to the service and they felt the staff were able to meet their needs. Many people had lived at the service for a number of years.

Care plans were developed from a preadmission assessment, and through people’s involvement, which included important health, support information as well as people’s preferences and backgrounds.

A staff member said, “The staff had been and spent time with them, so we had a very good idea on what they liked, how they ate, diet and general routine. The resident has flourished since admission and both the social worker and relatives confirmed this.” People and most of their relatives felt involved in this process.

The provider planned 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. However, care was not always delivered in accordance with plans, in particular in relation to mealtimes.

People and relatives said they had enough to eat and drink, sufficient choice and support. They were positive about the chef. A person said, “Food is ok, [choices] there are menus or you can ask. There is going to be a new chef starting at weekends.” A relative said, “My [person]r is on [specific diet], and they enjoy their meals especially that the chef is very talented.”

The mealtime experience was mixed. When some staff were supporting people to eat, some were chatting with people, others however did not, with 1 person having 3 different staff supporting them for the same meal. The person’s care plan stated they required no distractions or disturbances and found loud noises intense and could cause them to become distressed. We noted the staff were speaking with each other while supporting the person and also chopping/mixing the person’s food loudly on the plate. This was not supporting them in accordance with their assessed needs.

People could come for the meal at a time which suited them as there was no set time.

Tables were set with tablecloths, condiments and cutlery. Pictorial menus were available on tables. However, the chef had to change the options as they felt they hadn’t ordered enough chicken for a roast. Neither of the meals on the pictorial menu were served, but people had 3 options to choose from, and 2 people chose something completely different.

Observations and records showed drinks were offered throughout the day.

There was oversight of people’s weights. In September weights fluctuated with half of people in the home gaining some weight and half losing some weight. Where people were losing weight, there were plans in place to help improve calorific intake. Fortified meals were provided for those who needed them. People were referred to health professionals including a dietician when there were any concerns noted. However, 1 relative told us the staff did not do this quickly enough for their family member and they had to follow this up.

A health professional told us, “The care home team are very knowledgeable, and this shows through during training sessions, in which they can demonstrate easily when questioned upon such topics as dysphagia, hydration, IDDSI levels, waterlow and others.”

The provider 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.

People, and their relatives, told us staff knew them well. They told us if they needed any health care input this was sought. A relative said, “There is a GP attached to New Court Place who comes to the home every week and if there are concerns my [person] will see them.”

Staff told us they worked with health and social care professionals to ensure people had the right care and support. This included mental health teams, district nurses, Speech and Language teams, GPs and physiotherapists. Feedback from a visiting health and social care professional stated, “I find the staff responsive, kind and have nothing but praise for the way they care for the residents.”

Staff were familiar with signs of infection or changes and health and knew what action to take. However, another relative had felt there had been a delay in their family member being referred for a health check.

People’s care plans included a record of information obtained on their admission to the home. This was transferred into and informed the care plan.

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

Some people and some relatives told us they felt their physical, emotional and social needs were met. They said they had things to do to fill their time. A person said, “They do some group activities. Some people like karaoke. I like the computer thing we’ve got downstairs, playing the games on it. I like to go out shopping.” Another person told us they were supported to attend something important to them weekly. A relative said, “We would like our relative to get out of the home more, but I am not sure they have the right amount of staffing to enable this.” There was some feedback from people about they would like to go out more, but their 1-1 hours didn’t support that. A relative told us their family member was not receiving their required and allocated 1-1 hours. We discussed this with the management team who told us this had been missed and had now been reinstated.

Some people had chosen to stay in bed or in their rooms. Processes stated, and records showed, staff were going in routinely to support people to check on them and see if they needed anything. However, we did not observe much of this and interaction was mainly limited to when care needs were met. Other interactions were not observed by inspectors on the day of the visit.

A staff member said, “Care could be better if there was more staff.” However, another staff member said, “I believe care is person-centred, and staff make efforts to support people with activities, community access and meaningful engagement.”

In the communal areas, there was 1 small group of people in the activities room after lunch. However, we did not see what activity they were doing.

The provider 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 care needs were reviewed regularly and in between if needs changed.

Staff were able to explain how they monitored people’s health and wellbeing. They were aware of what action to take if needed.

There were systems in place to have overview of people’s care needs, wounds and infections for example, and this included progress updates.

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

People told us they were able to make their own choices. Relatives also told us people were supported to make their own decisions. We observed people being asked by staff before they did something to support them.

Staff were aware of the Mental Capacity Act 2005 (MCA). They were able to tell us how the principles of the MCA were considered in their day-to-day roles. For example, ensuring choices were offered to people and respected by staff. A staff member said, “I have received training relating to the Mental Capacity Act and understand the importance of supporting people to make their own choices and decisions wherever possible. We encourage independence while ensuring appropriate support is available.”

People’s care plans included information relating to capacity assessments. These included decisions relating to the use of bed rails and covert administration of medicines.

Plans stated where people had capacity to make day to day decisions, and also when more support was needed for more complex decisions. There was a record when Deprivation of Liberty Safeguards (DoLS) authorisations were requested. A DoLS authorisations tracker was in place so the progress of applications could be monitored. These were currently being reviewed due to recent changes in guidance.