Hill Barn 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 Requires Improvement. At this assessment the rating has remained Requires Improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to need for consent.

This service scored 54 (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.

People had detailed individualized risk assessments in place; however, this did not always match the information recorded in their care plans. Some people had been reviewed by the Speech and Language Therapists (SALT) due to swallowing concerns. We found discrepancies in their care plan related to the level of modified diet they required. We also found some discrepancies with the frequency that people required assistance to reposition to reduce the risk of pressure injuries. Some people’s care plans recorded that they required the use of the full hoist to transfer but did not always include the sling type or the sling loops they required. These discrepancies placed people at a risk of receiving the wrong diet or equipment being used unsafely.

We raised this with the service at the time, and they acted quickly to rectify these concerns.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. We viewed daily notes which were task focused and lacked person centred recording. We found they also included gaps in repositioning records and people receiving fluid and meals which differed from what had been recommended by the SALT team. One staff member told us, “We don’t always have time to document.”

These concerns had not been identified by the service. We raised these concerns at the time, and the service completed an investigation providing assurances that people had received the correct consistency of food and fluid and that it was due to staff documentation.

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. Staff worked collaboratively with health and social care professionals. We found that referrals had been made to different health professionals such as the SALT team, Occupational therapists, mental health teams and community district nurses. We received positive feedback from one health professional who told us, “There is always a senior about to help with risk screening. Seniors are fantastic. Staff consistently follow guidance. Communication is fantastic.”

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 provided with a variety of meal choices.

Planned activities included chair-based exercises to encourage people to remain active. We received positive feedback from relatives, with 1 relative telling us, “[Family member] came here after 4 weeks in a reablement hospital which was not effective in enabling [them] to restore capability. Hill Barn has helped me to get [them] to restore some of [their] movements. They’ve done a better job than the reablement hospital."

The provider did not always routinely monitor people’s care and treatment to continuously improve it. The service used clinical tools such as weight logs, bowel monitoring, food and fluid charts, repositioning records and behavioural monitoring charts. The service has systems in place to monitor some of these. Where concerns had been identified prompt actions had been taken. However, we found some inconsistencies with the recording and reviewing of other records, which had not been identified by the service. Meaning that opportunities to improve care and treatment could have been missed.

Despite this, the service worked well with healthcare professionals in regard to people’s behaviours and physical health needs.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. We found that consent to care and treatment had not been lawfully obtained in accordance with the Mental Capacity Act 2005.

The service had a detailed consent form in place; however, we found where needed corresponding mental capacity assessments had not been completed for the decisions recorded on the consent form.

Mental capacity assessments had been completed for other decisions; these had not been consistently completed and found to be of differing quality and quantity.

Where required, people had Deprivation of Liberty Safeguards (DoLs) in place or applied for.