Muscliff 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 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 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 service did not always make sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Care plans for people with multiple and complex health needs did not provide detailed guidance for staff directing them how to support people during times of distress. The service had not considered published guidance about best practice specific to a person’s health condition, such as dementia. A staff member told us, “There is some information available about individual needs and risks, but it is not always up to date or clearly communicated among staff. This can lead to confusion and may compromise resident safety.” This placed people at risk of avoidable harm.

However, people and their relatives told us their needs were fully assessed before moving into Muscliff Nursing Home and they had been positive about the process.
 

The service did not always plan and deliver people’s care and treatment with them, and did not always consider what was important and mattered to them. This was not in line with legislation and current evidence-based good practice and standards.

Evidence-based care and research was not always considered in the policies and procedures of the service. For example, the service’s moving and handling policy included tasks such as ‘safeholds’. Safehold, is a term used for using physical contact to restrain a person to prevent harm to themselves or others, staff must be trained and have their competency assessed to administer this type of support for people. The registered manager told us this is a “generic policy and each person has their own individual safehold care plan.” Safehold should only be used as a last resort. However, people’s safehold care plans lacked detail and did not guide staff in how to support someone to reduce their emotional distress before a safehold was used. This meant there was a risk people could be unnecessarily restricted.

The service 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.

People told us they were supported by staff to access healthcare as required. A person said, “I see the doctor when I want to talk about my tablets.” Relatives told us they were kept updated with changes. Records showed continual interactions with external health and social care professionals to support people’s overall care, safety and wellbeing.

A health and social care professional told us, “We have no knowledge or access to the operations of the home itself. However, we have found the staff to be knowledgeable of the patients and helpful in their interactions with us.”
 

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

People told us their general health and wellbeing had improved since living at the service. Relatives told us they had peace of mind and were confident their loved one were given the opportunity to have their needs met. A relative said, “Our loved one is registered with the medical practice; they contact the doctor, and they have referred them to a specialist clinic.”

Staff told us people’s health was monitored and changes made to ensure they remained as healthy as possible. An example of this is where the service monitored weight and nutrition and made changes according to their needs, such as where people needed to gain weight. People were given choices of food and drinks and staff responsible were involved in people’s care, this had supported the success of the intended outcomes for people.
 

The service did not always routinely monitor people’s care and treatment to continuously improve it. This meant outcomes were not always positive and consistent.

Staff told us not all records to support people were clear, and some felt additional training to support people to improve their experience of care at Muscliff Nursing Home was required. Comments included, “There is sometimes more emphasis on paperwork than on truly engaging with residents” and, “Working closely with residents who display vulnerable behaviours can be emotionally demanding, so providing more advanced training in this area would be beneficial.” However, people’s relatives did express their satisfaction about how the service helped to support their loved ones.
 

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

Principles of the Mental Capacity Act 2005 (MCA) were not always followed in practice, people were not always empowered to make decisions using guidance outlined in their care plans. Staff told us, “Decisions are made without truly involving the individual or their families” and, “Staff frequently talk over residents, ignore requests, or downplay issues.”

A health and social care professional commented, “Residents appear to be dehumanised as they are not being recognised as the adults they are.” However, people able to provide us verbal feedback told us they were supported with kindness.

The service had a clear process to carry out MCA assessments where required. Care was planned in consultation with those who had the correct legal authority to be involved in their care. MCA assessments and care plans had detailed all the options explored, including how the person was supported to decide and how the least restrictive care was planned as the outcome.