Burleys Wood

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 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Care plans demonstrated that people's needs were assessed before they were admitted to the service to ensure their needs could be met.

Staff knew people well and were able to talk about people’s care needs without referring to their records. They told us they didn’t always have time to read care plans to ensure the care they gave was in line with people’s needs. A staff member raised concerns that they did not have enough time to update people’s care records.

People’s care plans were personalised to them; their likes and dislikes were clearly documented. Care records contained recognised tools to assess the risk of malnutrition, weight loss, and skin breakdown. Care plans were regularly reviewed and audited by the registered manager to ensure they remained up to date and relevant to the person receiving care.

People did not raise any concerns regarding their care.

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

Staff knew people well. They monitored people’s health to ensure they would be aware if there was any decline which might necessitate a change in how care was delivered. However, staff gave specific examples where they were unable to meet people’s changing needs, for example due to their advancing dementia or behaviours that challenge. Staff said they, ‘Have been told not to complete [behaviour records]’ and told us how, ‘[People’s behaviour] has a huge effect on other residents and makes them very distressed, this can then lead to situations of residents reacting, shouting and hitting out.’ Staff told us, ‘The workload is very challenging,’ and, ‘They [management] do not look at the needs of the residents, but the number.’

Visiting healthcare professionals provided feedback which included, ‘From my observations, residents receive appropriate nutrition, hydration, pressure area care, and monitoring. Staff demonstrate good knowledge of residents’ needs and appear competent in delivering care.’

There were processes in place to ensure people’s care plans were regularly reviewed. We saw the registered manager regularly audited the care plans for completeness. Staff followed best practice guidelines and used recognised tools to assess and monitor people’s health. This included, MUST [Malnutrition Universal Screening Tool] to monitor nutrition and hydration; and Waterlow to monitor risk to skin integrity to ensure care was delivered in an evidence-based manner. The registered manager ensured staff received training in the appropriate legislative areas, such as the Mental Capacity Act 2005. This enabled staff to support people in the least restrictive way and where necessary in their best interests.

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.

The registered manager had good oversight of people’s care needs and how staff worked together with other services to ensure these were effectively met. This included when people were supported between services, for example, admission or discharge from hospital. Feedback from visiting healthcare professionals included, ‘Burleys Wood engages well… supporting early identification of deterioration, coordinated care planning, and efforts to reduce avoidable hospital admissions. Overall, my experience of working with the home has been constructive, with strengths in communication.’

Changes to people’s needs were communicated promptly. There was a staff handover meeting at each shift change. This gave staff time to exchange information. Staff had access to people’s electronic care plans via a handheld device. A member of the nursing staff told us how important it was to share information amongst the staff group.

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's health conditions were managed well, and staff supported people to access healthcare services. This included supporting people to access the GPs, dentists, opticians, and community matrons when needed. Care records contained details of multiple professional’s visits and care plans were updated when advice and guidance was given. For example, when people had a SaLT assessment [speech and language therapist] and specific dietary requirements were recorded and followed by staff.

Most people told us they were happy with the food. They told us there was a choice of food. One person said, “The food is very good here.” A relative told us, “Food is not good, [Name] hardly eats anything, they do not like the food. They get a choice of food from a menu, [it’s] more the quality of the food.” They also told us they had not raised this with the service.

The provider 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.

Staff monitored people’s health and wellbeing. Staff were clear in the actions they would take if people were unwell. Monitoring tools and records were kept for the monitoring of food and fluid intake, medical conditions, weight and skin conditions amongst others. Staff were alerted by the electronic care plan system when peoples care was due.

Staff recorded care interventions, and the management team monitored records to ensure care was provided appropriately and safely. The provider had systems in place to manage and report on incidents and complaints in order to improve outcomes for people.

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

Conversation with staff and our observations confirmed staff had an understanding about consent and put this into practice by taking time to establish what people’s wishes were. We saw people made their own decisions and staff respected their choices. People told us they were involved in shaping their care and making decisions around this. Staff followed people's documented wishes. People's right to decline care was understood. People told us they were not restricted.

When people lacked the mental capacity to make decisions, the provider met with relatives where appropriate to ensure any decisions made, were in the person’s best interests. Staff promoted people's rights and worked within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. The provider had requested legal authorisations where restrictions were in place. Decisions around these were made in people’s best interests and for their safety.