Estervin Court Residential 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.

This is the first assessment for this newly registered service. This key question has been rated 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 1 legal regulation in relation to gaining people’s consent to their care.

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.

The provider failed to ensure there were care plans for people’s known health conditions. For example, for 1 person who required a care plan for distressed responses, this was not in place. As a result, staff did not have guidance on how the person’s responses toward other people and staff, or how to support them.

The provider did not always complete reviews of the care plans, within their own timescales. The provider did not always sign the care review, or evidence the person was involved in this process.

The provider did not always have detailed care records kept by staff detailing relevant information for the people on a day-to-day basis.

For people whose first language was not English, they did not have their care plan information available to them in their preferred language to allow them to be effectively involved in their support planning and review.

We saw evidence the provider had consulted with family members in the care planning for 1 person and this input was reflected in their care plans.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

The provider failed to ensure people’s care plans included all their needs, including health, social interests, and activities.

The provider did not ensure all concerns raised in the pre-assessment paperwork were risk assessed. This resulted in missing risk assessments for some people including environmental risk assessments.

People were not always involved in their care planning and the information recorded in care plans was not always accurate. resulting in some care plans not being created, and risked people’s needs not being recognised or met.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

People’s care plans did not always reflect their level of need. This could prevent other health care professionals from having an accurate understanding of the person’s needs. For example, where visiting health professionals were supporting 1 person, there was a lack of guidance around the person’s responses and triggers which led to inappropriate behaviours.

The provider demonstrated they communicated well with other healthcare professionals, documenting the information appropriately and bringing the information to the rest of the team at the team handover meetings. This information was recorded on the person’s communication record. This ensured staff had access to information regarding potential changes in a person’s assessed care needs and this is detailed at the staff handover with the shift manager.

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.

The process to ensure care records and risk assessments were reflective of the support people required with their health needs was not robust. This meant staff did not always have the correct guidance on how to support people appropriately to manage their health and wellbeing, whilst encouraging independence.

People told us they were able to make choices and decisions when accessing the community.

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.

The provider did not routinely monitor people’s health conditions. However, they did daily monitoring for 1 person’s blood pressure. Although the staff had no training to complete this task, nor did they have guidance on how to escalate this to other health professionals.

When speaking with people about the goals they had achieved, they spoke about them in a positive manner and in detail. We saw the provider had commenced working with people to achieve their desired goals and explore their aspirations. These included reuniting with family members, going on holiday, and integrating into the community with minimal assistance and promoting independence. We saw this was the case with 1 person but had not been implemented with other people using the service yet.

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

The provider was not compliant with the Mental Capacity Act (MCA) 2005. The provider could not be assured people were being supported in the least restrictive way and decisions were not being made on people’s behalf were made appropriately. Where best interest decisions had been made on people’s behalf, these were not clearly recorded in people’s support plans. The provider detailed people’s capacity, ability to consent and support needed to make decisions, at the initial assessment stage. However, the provider did not always action documented changes in ability to consent. Information was not updated or reflected in the person’s care planning. Increased the risk of a person consenting to something when they did not have the capacity to do so.

The provider did not always carry out best interest meetings, nor consult family or advocates, for people when making decisions on their behalf and no documents were signed by people to consent to certain restrictions imposed on them. This included access to the designated smoking area and communal areas of the building, outside of specified times.

We found most staff had received training in MCA and DoLS. The staff we spoke to understood what these were and what this meant for people.