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 requires improvement. At this assessment the rating has changed to 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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Since our previous inspection, improvements had been made and people’s health and well-being needs were now consistently assessed.

Relatives told us they felt involved in people’s care and, where appropriate, were invited to reviews. One relative said, “[Person] cannot really communicate effectively anymore, but is still asked about their needs and wants very regularly. We are in constant communication with nursing staff and received an updated care plan last week.” Another relative told us, “[Person's] care plan was reviewed with me again recently.”

Records showed people’s needs were reassessed at least monthly, or more often if their support needs changed. We saw records which showed family members had been provided with copies of care plans and changes had been discussed with them.

The provider had made the decision not to admit people to the service whilst improvements were made. Processes were in place to support people’s admission to the service. Staff told us the usual process was for a nurse or manager to visit people and assess their needs prior to moving in. A staff member said, “The pre-assessment process forms the basis of the care plan, which we then develop in more detail as we get to know people.”

The service 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.

Since our previous inspection, improvements had been made and people were now receiving consistent care in line with their preferences and best practice.

Nationally recognised tools were used to assess and monitor people’s needs and risks. Support and advice were sought from external health professionals when required and care plans included the outcome of those reviews.

A health and social care professional said, “The team demonstrates a strong understanding of residents’ individual needs. When new residents are admitted, they ensure that appropriate medication supplies are arranged without delay. They are attentive to changes in clinical requirements and actively seek guidance regarding medications whenever necessary, reflecting a resident-centred and safety-focused approach.”

The service used an AI powered pain assessment tool to assess for pain in people with dementia and cognitive impairment who had difficulties communicating. The application used smartphone cameras to analyse facial expressions for detecting and quantifying pain in real-time. This meant the service was able to improve pain management.

Care plans for people with complex needs were detailed and included best practise guidance. When required, people’s weight and fluid intake were monitored and recorded on the provider’s electronic system. People’s dietary requirements such as allergies, likes, dislikes and SALT plans, were included in their care plans.

People and their relatives were complimentary about the food. People were asked about their likes and dislikes in a recent survey, to ensure these were incorporated in the new and revised menu plan. One relative told us their loved one was on a modified diet and, “Staff will bend over backwards to encourage [person] to eat and drink as often as they can.” Another relative said, “The food is well prepared and tasty.”

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.

Communication between health and social care systems was effective. Regular dialogue took place with professionals, including GPs, this supported staff to respond promptly when peoples’ needs changed. A staff member told us, “The GP, pharmacists and nurse practitioners meet every week, so we send a report for people we want reviewed. That team go through the report and 1 of them might come here and review someone we’ve asked about. For example, [person] was having lots of falls, so they came and reviewed [person] to see if there was an underlying cause or if they needed a referral to the falls clinic. They are very good and we get lots of support from them.”

We saw records which showed people’s clinical presentation was assessed in full before external advice was sought. Staff reacted proactively to a deterioration in people’s health.

Health and social care professionals were complimentary about working with the service. A professional said, “In terms of flexibility and continuity of care, staff respond promptly to any medical or medication-related queries and ensure that issues are resolved quickly and appropriately. Their proactive approach helps maintain continuity of treatment and minimises the risk of delays or disruption to residents’ care.”

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 were supported to be as healthy as possible. Records showed that people had enough to eat and drink. People’s weights were monitored, and when people had lost weight, action was taken. The manager told us they introduced snack boxes for people. This was then stopped. As the service closely monitored people’s weight and noted a small decline in their weights, they reintroduced snack boxes and staff support.

We observed staff regularly offering and supporting people with drinks.

There was access to a secure garden for people to get fresh air during the warmer weather.

The service had effective working relationships with a wide range of health and social care professionals whose input was recorded on the provider’s electronic system.

The service 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.

Since our previous inspection, the provider made improvements to how they monitored people’s care and treatment. People were now experiencing consistently good outcomes.

Regular care plan reviews enabled staff to have full oversight of people’s needs. Reviews led to changes in people’s care and positive outcomes. For example, following a fall, we saw 1 person’s care plan had been reviewed and they had been assessed for the use of additional equipment to keep them safe.

Staff used the electronic care planning system to monitor people’s health daily.We reviewed records for people who had experienced periods of anxiety or distress. These records were completed by staff and included details such as what might have triggered the episode, and how staff supported the person to feel calm again.

The service held weekly clinical meetings to ensure an effective approach to monitoring people’s care and treatment and their outcomes. This ensured continuous improvements were made to people’s care and treatment.

Relatives told us the service monitored people’s care and treatment and their outcomes. Comments included, “All possible precautions are being taken to ensure that [person] stays safe, we have had regular updated care plans and are in constant discussion with staff, receiving regular updates on [person’s] condition. They have recently requested a review of [person’s] condition and medication by the GP and immediately advise us of any changes in her condition or areas for concern.”

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

We observed staff consistently gaining people’s consent prior to offering support or care interventions. For example, we saw staff supporting 1 person to move from an armchair to a wheelchair and they asked, “Are you ready?” A staff member came into the lounge and asked people, “Are you watching the TV or would you like me to put some music on?" When 2 people said they were watching the TV, the staff member respected this and left the TV on.

Staff confirmed they had completed relevant training and understood people’s rights around consent. One staff member said, “I have completed training on the MCA, and I apply it regularly in my role as a carer. The MCA is essential in ensuring that the individuals I support are empowered to make their own decisions wherever possible. In my role, I always follow the five key principles of the Act. My MCA training helps me promote independence, dignity, and person-centred care while safeguarding the people I support.”

Another staff member told us, “I have completed training on the MCA. This training helps me understand how to support residents in making their own decisions wherever possible, while also ensuring their safety and wellbeing.”

Although mental capacity assessments had been carried out, they were of an inconsistent quality. Records were not always decision specific, and when best interest decision meetings had been held, records did not always detail how the decision had been reached and if any, less restrictive options had been considered. We fed this back to the management team who told us they had been providing staff with refresher training and would review these records for all people at the service.