Chilton Meadows 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 inspection we rated this key question good. At this inspection 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.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People living with specific clinical conditions did not consistently have care plans and risk assessments in place for these. For example, one person had Diabetes but there was no specific care plan in place for this and other care plans relating to this contained conflicting information. This left people exposed to the risk of staff not understanding their specific needs.

A health care professional told us how some people’s assessments, prior to moving to Chilton Meadows were not always effective, however the provider confirmed there had been no failed admissions to the care home.

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.Care plans and associated risk assessments showed a lack of robust guidance for staff, with actions required or taken to mitigate risk not accurately recorded.

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

Best practice guidance on diabetes management was not included in people’s care plans. For example, as mentioned in the key question of safe, some people did not have care plans specifically for safely managing their diabetes.

We were concerned there was not a consistently reliable system in place for staff to know who had a fluid target in place to maintain their hydration. Staff did not reliably record what people drank. The oversight of what people drank daily to ensure people remain hydrated was not adequate.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

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. Systems and processes were not in place to support people's health and wellbeing. Care plans and risk assessments, for some people, did not contain sufficient information and were not regularly reviewed to ensure peoples' care and support needs was appropriate. There were inconsistencies between the 4 units.

We found care plans, particularly on Constable Unit were detailed and personalised and people were receiving good outcomes. One person told us, “I was a bag of bones when I moved here, but I have put on a stone and half. Well done to these people.”

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. We found mixed evidence on how staff supported and monitored people’s care and treatment to continuously improve it. Care records did not always evidence that people received their planned care. We were not confident outcomes were always positive and consistent.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. We received and observed mixed feedback across the units. Whilst some staff on Gainsborough and Constable Units promoted people’s right to make their own decisions, some practices on Munnings and Beech were overly restrictive such as actively preventing people from accessing a secure outdoor space. We also observed occasions where people were attempting to walk and move, and staff were telling them to sit down again. This did not respect people’s rights.

People's capacity to make decisions related to their care and treatment had been considered, and authorisation had been sought to deprive people of their liberty where required. Capacity assessments and best interest decisions were in place when needed to ensure the Mental Capacity Act was applied. Staff had received training in this area and were aware of the processes to follow, however, this did not consistently transpire into people’s care experience as referred to in this inspection report.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations had been requested to deprive a person of their liberty.