Chacombe Park

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• 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

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 remained Good. This meant people’s care and treatment was effective and supported positive outcomes. People’s needs were assessed and reviewed regularly, and care was planned in line with best practice tools. Staff worked well with professionals such as GPs and therapists, and people experienced improvements in health and wellbeing. Staff understood the principles of the Mental Capacity Act (2005) and supported people to make decisions where possible, although documentation of capacity assessments and best interests required strengthening.

This service scored 71 (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. Assessments were thorough, covering health, nutrition, preferences and personal routines. People’s preferences and decisions were clearly recorded in their care plans, which helped staff deliver personalised support. There were also processes in place to ensure staff were kept up to date when people’s needs changed, such as through daily handovers and the “Resident of the Day” system. Relatives confirmed the positive impact of this approach, with one saying, “Mum has had a new lease of life, she is quite a performer, but she genuinely seems happy.”

The provider planned and delivered 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. Tools such as Malnutrition Universal Screening Tool Waterlow and falls risk assessments were consistently used to monitor people’s health and wellbeing. Staff also followed a clinical deterioration escalation procedure which referred to the National Early Warning Score (NEWS) tool, helping them to identify and respond promptly when people’s health was deteriorating. Actions were taken when risks were identified, such as referrals to dieticians and use of pressure-relieving mattresses. Relatives also described improved outcomes, with one relative saying, “He has put on four stone in weight, physically he is the best he has been for the last five years.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing assessments with external professionals. Staff worked closely with GPs, therapists and dieticians, and visiting professionals praised the organisation and communication. One GP said the home was “very good” and that the team was “a pleasure to work with.” Staff also told us they had ready access to people’s care plans, which enabled them to deliver appropriate and consistent support. They described communication within the team as effective, with daily handovers used to share new information and instructions so that people’s needs were met without delay.

The provider supported people to manage their health and wellbeing to maximise independence, choice and control. People had their vital signs monitored, weight tracked, and referrals made promptly when concerns were identified. Records showed staff worked closely with external professionals to coordinate care effectively and ensure people received the right support at the right time. People also told us they were supported to access healthcare services whenever they needed them. Staff demonstrated good knowledge of people’s individual needs and how to promote their health and wellbeing in daily care. As a result, people achieved positive outcomes, with one relative telling us, “He was bedridden but now strolls around the grounds.”

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. Records such as repositioning charts, falls logs, catheter care and fluid charts were completed without gaps. Trends in accidents and incidents were reviewed monthly in team meetings to identify learning. For example, refresher training was introduced following a safeguarding review of a mobility incident. Managers monitored infection rates and activities outcomes to check people were benefitting from the care provided.

The provider did not always ensure people’s rights around consent were fully recorded or consistently evidenced in documentation. While mental capacity assessments and best interest decisions were in place, they often lacked sufficient detail and did not cover all areas of care. In one case there was a short delay in renewing a DoLS authorisation, which reduced oversight of safeguards.

However, staff had received training in the Mental Capacity Act (MCA) and understood the importance of giving people time to make their own decisions wherever possible. Our observations confirmed staff supported people to express their views and respected their choices. The manager understood their responsibilities under the MCA and DoLS and ensured that people and their representatives were involved in best interest decisions. Leaders also acknowledged the shortfalls in documentation during the inspection and took immediate steps to strengthen records and oversight.