Eglantine Villa 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 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 did not always make sure people’s care and treatment were effective because some information was inconsistent. The provider checked and discussed people’s health, care, wellbeing and communication needs with them. Assessments were completed before people moved to the service. These assessments were used to develop the person’s care plans and make the decisions about the staffing hours and skills needed to support the person. The assessment included making sure that support was planned for people’s diversity needs, such as their religion, gender, marital status, culture and their abilities. However, when assessments were updated and amended the changes were not always amended in the person’s care plan which led to inconsistent information. We reported this to the management team and actions were taken to address the inconsistencies. Assessments included information about what people could do for themselves. Each person’s care plan and assessments were also reassessed once a month as part of the ‘resident of the day’ process. This ensured that every person’s care plan and risk assessment was updated at least monthly. People were reassessed as their needs changed to ensure the care they received met their needs.

We received mixed feedback from people about how they were involved in their assessments and care planning processes. Comments included, “They have asked me about what I would like, and I think that’s been twice now”; “I did at first, but I don’t know of any changes as I trust them” and “I have input into my care plan, and we review it regularly.” We received mixed feedback from relatives about how they were involved in the assessment and care planning process. A relative gave us an example of when an assessment had not been updated as it should. This meant when their loved one was admitted to hospital along with the hospital passport, the hospital had out of date information which led to their loved one receiving medicines at the wrong dose. Another relative said, “I have not been involved in care planning. They review the care plans monthly. I was called once about this, but it would be nice to be called and involved in the monthly review.” Another relative said “They’ve involved me in discussions about the care plan.” A staff member told us they were involved in writing care plans and assessments. They said, “I write the care plans and try to make it clear. I try not to abbreviate medical terms.” We observed that staff knew people well.

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 as well as the provider's dementia strategy. The provider had systems and processes in place to meet people’s nutrition and hydration needs. However, it was not always evident that drinks were offered in a timely manner as we viewed many overdue fluid reminders on the online care planning program. Records showed that people were not having enough fluids to keep well. We discussed this with the registered manager. They felt this was a recording issue and added this to the action plan for improvements, but needed to investigate this further to make sure. We observed people being prompted and encouraged to drink throughout the day.

Care plans and risk assessments clearly described what modified diet people were prescribed and the care plans followed The International Dysphagia Diet Standardisation Initiative (IDDSI) framework. The guidance was also available in the kitchen to staff responsible for preparing, cooking and serving meals. Kitchen staff and those responsible for supporting people with their food had a good understanding of people’s assessed needs in relation to type and texture of food as well as any allergies and food intolerances. Staff told us they helped people to make their meal choices if they needed it. We observed kitchen staff asking people what food choices they would like.

We received positive feedback about the food. Comments included, “The food is nice, most of it. I can make a choice. I can ask for something else. There is plenty to drink, I prefer to drink water, I get hot drinks regularly”; “Mum is very complimentary of the food”; “She eats and drinks well on the days she is more awake. She enjoys food and is on supplements too” and “The food is very good.”

The provider always worked well across teams and services to support people. They sharedthorough assessments of people’s needs when they moved between different services, sopeople only needed to tell their story once.The provider had a clear process in place to escalate health concerns within a timely manner. They had reviewed and amended the process to learn lessons from where things had not worked quite as well. People’s care plans included hospital passports. The service had sourced a dementia bus to provide an experiential learning experience where staff were enabled to understand how it felt to live with dementia and how it affected every aspect of life. The registered manager told us, "We did this because we want our staff to be as equipped as possible to provide the best possible outcomes for our residents. We also invited relatives to join in the experience as we recognise that there can often be a lack of understanding from relatives about how Dementia presents itself."

Staff worked with health professionals to ensure people got the care and support they needed. We requested feedback from healthcare professionals about the service but did not receive responses. The registered manager and nurses told us, they worked with the local hospice when people were at end of life, to seek advice and support. Nursing staff and other staff told us there were good links with other health professionals such as SaLT (Speech and Language Therapy), the GP, TVN (Tissue Viability nurse). A staff member told us, “The local frailty nurse comes weekly on a Thursday.” Trained nurses within the service reviewed and updated people’s clinical records daily if they required nursing care. People told us staff worked with GP’s and health professionals to meet their health needs. A relative said, “I raised some deterioration, and they got the frailty nurse involved, reviewed medicines, added supplements, they were responsive.”

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 told us they were supported with their healthcare. A relative said, “They are responsive to her health needs.” The GP carried out a weekly visit and the frailty nurse visited weekly too. People living at the service had access to onsite nurses employed by the provider and other health care professionals, for example, the community mental health team, chiropody, dietician, dentists and SALT (Speech and language therapists). Visiting was encouraged and people were supported to attend medical appointments. Staff had a good understanding of meeting people’s changing needs. A staff member told us, “We have a good relationship with the GP who visits every Friday. Any concerns, we email him with the obs [medical observations of vital signs], and he will respond within the day.”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. Staff worked together as a team to support people and to ensure people received their care and support in the way they chose. The service had trialled ways to reduce falls. They had taken part in a decaffeinated drinks project in May to August 2024. They had reviewed numbers of falls from March to May 2024 before the project started and then from May to August 2024 when everyone was given decaffeinated drinks. The results showed less falls as a result, so the service has adopted this approach going forward. The information at the service showed that drinks were now available as decaffeinated. It stated people were aware and people and visitors could still have caffeinated drinks if they chose. The project came from Health England and Stow Healthcare and University hospital of Leicestershire trust. The service had also embedded a ‘Mealtimes Matter’ programme. Mealtimes Matter is the process of all roles and departments supporting with people’s meal service to maximise efficiency, making it a more sociable experience and giving lunch time the care and attention it needs to ensure peoples nutritional requirements were met. We observed this taking place across the service.

Staff across the service had become champions within the service to drive improvement. Champions were in place for a number of different important areas such as skin care, continence, infection control, end of life, dementia, and safeguarding.A staff member fed back about skin care and their role in the service. They said, ‘As a champion for skin and wound care I make sure that I keep up to date with the latest evidence-based practice and I cascade this to the team.’ They explained they shared this at handovers, on a one-to-one basis and via [group chat]. They shared they regularly reviewed the wound plan or any skin integrity plans for people and felt able and comfortable to escalate any concerns or uncertainty that they had. They went on to say, ‘I have very good professional relationship with the Tissue Viability specialist nurses helping me and the team to refer, escalate or discuss any issues we may encounter. I have been attending training regarding the type of wound and how to choose a dressing based on the assessment of the wound, and I found this extremely beneficial. I have regular reflective restorative clinical supervision with the clinical deputy manager (CDM) by observing me when I assess and dress a wound to ensure that the residents receive the best care in line with Bupa pledge to give exceptional clinical care.’ A relative said, “She had a problem with her heel, they are keeping good checks, and they are on top of her health needs.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We checked whether the service was working within the principles of the Mental Capacity Act (MCA), whether appropriate legal authorisations were in place when needed to deprive a person of their liberty. The service worked within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. When people were assessed as lacking capacity to make decisions appropriate procedures were followed to ensure principles within the MCA were followed. Decisions made were appropriately documented to demonstrate who had been involved in the decision. People had signed consent forms within their care records. Deprivation of Liberty Safeguards (DoLS) applications and authorisations were in place for people around any restrictions within their lives that they did not have capacity to consent to. Systems to review these were also in place.

People's ability to consent to care and support had been assessed. Care was person centred: People were offered choices throughout the day and people told us they felt listened to and their views and opinions were important to staff. People said, “I have choice in what I do. I get up early for the toilet and I stay up which is my choice”; “I make my choices” and “I can do what I want when I want. I get up early and go back to bed for a few hours. I get up for breakfast. Sometimes I’d like to come down earlier, but I understand they have other people to care for.” A relative told us, “I am LPA (lasting power of attorney) for health and welfare, and they involved me in decisions around her COVID vaccination.”