Horton Cross Nursing 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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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.

Pre-admission assessments were completed by the registered manager and clinical lead for all new people, including capacity assessments. Staff reviewed people’s care plans monthly and after any change in their needs.

Care plans were person-centred and regularly updated. Relatives said they were involved in reviews: “They always ring me if there’s anything wrong. It’s excellent.”

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.

Nationally recognised risk assessments for skin integrity and malnutrition were used consistently, and actions were put in place when high scores were identified. For example, additional pressure-relieving mattresses were purchased. Staff told us, “We always check care plans and handover notes so we know what each person needs.”

Clinical audits were completed monthly, and findings were shared at governance meetings. Medicine safety had improved at the home after switching pharmacy providers, reducing delays. One nurse told us, “We always give 100% and that to me is what it’s all about.”

An external healthcare professional praised the wound care at Horton Cross.

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 staff, worked well together to deliver coordinated care. There were daily flash meetings for heads of departments to ensure effective communication across the home. Staff used WhatsApp groups and handovers to share updates. The provider used electronic care planning records which staff had access to. Staff told us they felt well informed about people’s needs.

There was effective collaboration with people’s GPs. A designated healthcare professional paramedic visited weekly or as needed on behalf of the GP surgeries to triage clinical needs, which staff said worked well.

Relatives told us, “They always ring me if there’s anything wrong,” and staff described teamwork as “Very good, we all help each other.”

Staff told us they worked well as a team to meet people’s needs. Comments included, “We work as a team, everyone does their bit” and that during lunch “domestic staff also help to take food and fluids to people in their rooms who can eat independently”.

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.

People were weighed regularly, and their dietary needs were met. A snack and hydration station was available, and menus were adapted for individual preferences.

Activities included chair exercises, baking, and gardening, promoting physical and emotional wellbeing. Staff said, “We encourage people to do things.” Relatives praised the home’s approach: “Activities are very good, classes, games, jigsaw puzzles, books on the shelves.”

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.

People felt staff were attentive and knew when their needs had changed and involved health professionals appropriately.

Care plans were regularly audited to ensure reviews were completed and any identified actions were followed up. Staff confirmed, “Lessons learned are shared, and changes are made straight away.”

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

People’s consent was sought, and decisions were made in line with the Mental Capacity Act.
Capacity assessments were completed at admission and reviewed regularly.

On the first day of our visit, Inspectors noted that consent for clothing protectors at mealtimes was not always sought; this was addressed promptly.

Best interest decisions were documented for covert medication and use of lap straps, involving families and GPs. Staff had completed MCA and DoLS training and knew who had authorisations in place.

Relatives confirmed they had been involved, comments included, “I was asked about powdered medication, and the GP was involved in that decision.”