Foxby Hill 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 meeting nutritional and hydration needs.

This service scored 46 (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 did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Risk assessments did not fully explore potential associated risks in relation to people's care and treatment. For example, falls risk assessments were not always present and did not always contain detail regarding the use of mobility equipment.

One relative described how they did not feel involved in their relatives care and were not kept informed. They told us, “We always have to ask for information, and don’t really know what’s going on.” Records indicated that people and their relatives were not always included in decisions about their care.

The provider did not plan and deliver people’s care and treatment with them. People’s care and support was not always delivered in line with relevant legislation, national standards and evidence-based good practice guidance.

Assessments were in place to understand people’s needs, however these were not always effective. For example, hydration assessments did not always fully explore what good hydration looked like for people so staff could ensure they had enough to drink. Monitoring records were also not reviewed effectively to ensure people received enough to drink.

Feedback from people and their relative’s indicated people were sometimes hungry. While lunch was being served a person said, “I’m hungry. This is taking too long.” Mealtimes were not always appropriate for people to promote good nutrition. We observed people finishing their lunch at 14:00 and staff informed us people would then be offered their evening meal at 16:30, only 2.5 hours later. This was not a suitable amount of time to build up an appetite and ensure meals were well spaced throughout the day.

People did not have access to fresh fruit, vegetables or salads. All meals at the service were reheated ultra processed foods, no meals were freshly cooked at the service. Some people were not happy with the quality of the food. One person said, “I never have a choice and it’s always watery.” People’s mealtime experience did not always promote dignity as tables were not always dressed, and staff did not always ensure condiments and napkins were always available.

The provider did not always work well across teams and services to support people.

Staff did not always work together or with external health care professionals effectively to ensure people’s needs were met. We observed a community nurse provide a staff member with instructions on how to support a person following their visit. However, this information was not logged into the person’s care records to ensure effective communication and the care instructions provided were not followed. This meant the person did not receive the care and treatment prescribed by the visiting health care professional, and they were exposed to an increased risk of potential harm.

Some staff felt information was not well communicated between leaders and care staff but indicated this was improving. Staff commented that the lack of consistent leadership at the service had impacted how effectively the service operated.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise 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.

Staff expressed kindness and compassion for the people they supported. One person told us, “I feel looked after and safe. The staff are very kind.” However, systems of care were not always effective at ensuring consistent care to promote people to live healthier lives. For example, ineffective risk management meant people were not always supported safely. Failure to engage with external health care professionals consistently meant people did not always receive the health care they needed.

Some people did not feel they had full choice and control over their daily routines. One person told us, “They wash me in bed at 5am, which is too early for me.”

People were supported to engage in life enriching activities such as games, visiting entertainers, and trips into their local community. People and their relatives spoke positively about activities staff and available options for things to do.

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.

A range of systems were in place to monitor people’s care and treatment. However, these were not always used effectively to ensure continuity of care. For example, repositioning records indicated some people were not always repositioned as required. Whilst there was no indication people experienced harm, the lack of effective monitoring meant the provider could not be fully assured people received the care and treatment required to meet clinical expectations.

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

Where people lacked mental capacity to make decisions, assessments were not always in place to ensure the provider understood people’s needs fully and how best to support them with decision making. In some instances, capacity assessments had been completed, but they were not always completed in line with the principles of the Mental Capacity Act 2005 as they did not contain sufficient detail.

Staff mostly understood the need to gain consent during daily care activity. However, not all staff promoted dignity and respect in this manner. For example, during meal service staff did not always remind people of their meal choices. In some instances, we observed people being told to sit down by staff who did not respect their decision to leave their chair or environment.