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

The provider was previously in breach of legal regulations in relation to consent. Whilst we found improvements had been made, further work was required, and the provider remained in breach of this regulation.
 

This service scored 58 (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 care and treatment were effective because they had not ensured everyone had a detailed care plan. There was a lack of a systematic process to determine the frequency of care plan reviews.

All but 1 of the care plans reviewed contained detailed information about the person’s health, care, wellbeing and communication needs both within their initial and current assessments. These informed staff and enabled them to provide people with effective care. One person’s care plan was limited in content and did not provide a sufficient level of information for staff to provide effective care. However, there was limited impact, as the staff team knew people well. Agency staff confirmed they were provided with sufficient information to support people effectively.

Relatives said the provider maintained regular contact with them and sought their views about their loved ones’ care. Whilst the provider’s assessment of need and eligibility policy required people’s care needs assessments should be reviewed at least annually. Their electronic care planning system showed people’s care plans had not always been reviewed as often as required. There was not a systematic process to determine the frequency of reviews of people’s care and to monitor they took place.
 

The provider had not ensured all staff were up to date with training in good practice related to modified diets.

Staff had not all completed or were not up to date with their dysphagia training, including 2 staff who prepared people’s meals. Kitchen staff were informed of the consistency of the food people needed and their preferences. Whilst there was no evidence people had not been provided with a meal of the correct consistency for their needs and safety, not all staff were appropriately trained in this area.

People's records did not demonstrate they had been offered the level of fluids they needed. However, from our observations and speaking with professionals we were assured people were sufficiently hydrated. Staff were not fully recording all the drinks people offered and consumed. This meant it was not clear whether people were having enough to drink.

There was only one option for the main meal and supper. However, people were provided with an alternative if they did not like or want the meal provided. We saw where people required a modified diet each element was prepared separately. People were weighed weekly, to ensure their weight was monitored and any required action taken.

The provider ensured staff used a range of recognised clinical tools to assess and determine people's needs.
 

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.

Staff worked together well as a team across the inspection. People’s care plans were sufficiently detailed to guide staff about how to respond effectively where people communicated their needs and emotions through their actions. We heard staff as they supported a person who was struggling to regulate their emotions in a calm, positive and person centred manner, which reflected the written guidance in their care plan.

The provider had processes in place to record and share information across the team, such as records made after the weekly GP ward round.
 

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.

The provider was not using tools such as RESTORE2 mini for care homes, which was referenced in their meeting needs policy. They informed us they planned to make use of this nationally recognised tool which enables care staff to identify and escalate signs of a person deteriorating. Staff routinely completed people's observations and had a good understanding of people's usual presentation in the event this changed.

People who experienced seizures had information in place for staff to follow. Staff had completed epilepsy training and had access to the provider’s guidance.

People had access to a weekly GP ward round, podiatry, optician and hearing services.
 

The provider monitored people’s care. They ensured outcomes were positive, and that they met both clinical expectations and the expectations of people themselves.

The provider had an assessment of need policy which informed staff about people's expected outcomes from their care. People's care plans noted the planned outcomes from their care in relation to their needs, what was relevant to them and their wishes for their care.

The provider had not obtained written evidence of people’s consent to their care or recorded how they ensured legal requirements were met where people lacked the capacity to consent.

The provider advised, 2 people had capacity to consent to their care. However, whilst a person’s records demonstrated they had been consulted about a range of decisions related to their care, their records lacked any documented consent.

The provider advised everyone else lacked the capacity to consent to their care plan. Where a person lacks the mental capacity to make a specific decision, staff must act in accordance with the requirements of the Mental Capacity Act (MCA) 2005 and associated code of practice. Whilst relatives confirmed they were involved by staff in decisions, people’s records lacked written evidence to demonstrate where MCA assessments and best interest decisions had been made for people.

However, where people had a appointed a power of attorney to make decisions, relevant checks had been completed. Staff had completed MCA training and understood its application in relation to their role. Staff had access to the provider’s MCA guidance.