Falcon House 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 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 lacked consistency.

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 did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The management team had a plan in place to ensure all care plans were reviewed, updated, and uploaded to the new electronic care planning system. We found however, these plans still required more details, to ensure they were fully reflective of all people’s needs. This would enable all staff to be able to understand people’s planned care and support needs.

For example, one person had contradictory plans in place for falls, mobility and moving and handling needs. This person was described in one section as being independently mobile, but in another as requiring mobility aids. This left the person at risk, of staff not having clear guidance available to support the person.

People and their relatives had not previously been involved in care planning, although they gave positive feedback about the inclusive approach of the new manager. One relative told us, “I always get enough information, I just have to ask.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We found improvements in diabetes risk management and monitoring for people. Multiple people required support to manage type two, diet-managed diabetes, where their sugar intake should be kept as low as possible. The information on the food and nutrition plan in the kitchen was reviewed and accurate. However, not all staff showed a clear understanding of how to ensure people received a low sugar diet, to support good health. We discussed with the management team, who ensured all staff were up to date with diabetes awareness training.

The management team worked to ensure best practice in dementia care was being followed. For example, one person was described as displaying distress behaviours. The records for this person showed some exploration of the antecedent, behaviour and consequences records, (ABC) for each event. This structured approach allowed care staff to understand potential triggers and impacts and can support effective interventions. The person was described as having a poor sleep pattern; and was being monitored during the night at 1 hourly intervals by staff. The service worked with an external team, to identify any triggers for the person and to provide support with better sleep hygiene. However, the records were split over multiple differing systems and had not been effectively analysed to reduce any risks to the person. We saw staff had a good understanding of people and their individual needs, and showed a calm, kind approach despite the gaps in care plans and paperwork.

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.

The management team had worked hard to rebuild positive relationships with external health and social care teams. We saw the service had a positive relationship with their covering GP practice, who visited regularly to carry out ward rounds, and as needed when requested.

We saw people who required review for their specific needs, such as falls management, dementia or diabetes, were referred to external teams promptly. The management team acknowledged the advice from these teams could be made clearer within the electronic care planning system. The management team had a plan in place to ensure this information was centrally stored moving ahead. People and their relatives were positive about the improvements made by the management team. One relative told us of the improvements in their family members continence support, “The carers now take my family member to the toilet regularly. Also, their bottom denture broke recently, and the staff promptly arranged a dentist to visit.”

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.

For example, one person lived with a clinical diagnosis which impacted on their breathing. The care plan in place for this condition did not explain what Chronic Obstructive Pulmonary Disorder (COPD), is or what staff should look for. The care plan stated the person should be referred on to a specialist nurse to support with managing their condition but did not detail if this action had been completed. Another person had details within their care plan for skin management. The plan stated the person had dry skin and went on to state the person did not have any skin creams prescribed. However, prescribed cream was found in the bedroom of the person. We raised the concerns around the lack of clarity within these records with the management team. The management team submitted amended documents which we were assured by.

We found improvements in the provision of good nutrition to support positive health and wellbeing for people. The kitchen team showed a good level of knowledge, and improvements in the quality of food had been noted by people. One relative explained how they had been invited to spend Christmas lunch with their family member, they told us, “I visited for Christmas day, it was the best meal I’ve had all year. The food always looks good and is different. The menus look good. My family member eats fine. There are lots of drinks available.”

Feedback on the food was generally positive, with menu choices being offered and snacks available on request and from the tea trolley. One relative told us, “There is a good variety of food on the menus which is appropriate to this generation.” Another relative told us, “The food is really good, it looks and smells delicious. I have no gripes.”

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.

Feedback we received from people and their relatives indicated the service worked in partnership with external agencies. However, we found the care plans, risk assessments and daily records for people were not always promptly updated when a review had taken place. This left people living at Falcon House with potential unmet needs. We raised this with the management team, who provided updated records, showing the inclusion of guidance from external teams, and improved daily and night records.

People and their relatives were positive about the improvements made by the management team in ensuring prompt referrals were made to external teams.

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

People and their relatives felt more confidence in the approach of the management team, in ensuring their consent and wishes were sought. We saw staff ask people for permission to enter their bedroom spaces, and prior to carrying out personal care. One relative told us, “My family member has started to become a late riser. I have visited a few times when they didn’t want to get up early. Staff respect their choices. [Name] is a favourite staff member of theirs and they explained to me that my family member won’t get up if they don’t want to. My family member will go to bed when they want to as well.”

Where people were deprived of their liberty, we found a Deprivation of Liberty Standards folder was in place which contained relevant paperwork. However, there was no tracker in place to monitor dates or compliance with imposed conditions. We discussed this with the management team, who shared an updated document for monitoring this moving forwards.

Mental Capacity Act (MCA) assessments were in place and were decision specific. Further information in how people, weigh up and communicate could benefit from being expanded upon, to show the conclusion reached. However, there was evidence of a discussion taking place with the person, using direct quotes from parts of the MCA.