Marlfield Care Home With Nursing

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.

Senior staff assessed people’s care needs using a pre-admission assessment form which considered their needs holistically. They then discussed with the registered manager whether the person’s needs could be met safely and effectively within the home.

People's care plans were developed, as staff got to know the person and their needs and preferences about their care.

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.

Staff used a range of nationally recognised tools to assess, monitor and regularly review people's care needs and risks. When staff identified a need or a risk for a person, measures were in place to address them. Staff’s guidance to enable them to manage specific needs such as wound care, reflected national guidance.

Staff were kept up to date with legislative requirements and good practice through their staff training and the clinical lead shared updates from their attendance at the provider’s clinical governance meetings. Where the clinical leads from each home shared good practice updates, discussed the outcomes from the trialing of new processes and reviewed and shared learning.

People's preferences, needs and risks in relation to nutrition and the risk of choking were recorded and met and kitchen staff were informed. Staff ensured where people were identified as at risk of weight loss, measures were in place to manage this risk.

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 closely with a range of external professionals to support people. A professional told us staff were, 'open and responsive' when working with them.

The provider had processes to ensure there was effective recording of guidance from external professionals, which was reflected in people’s care records. Staff were then updated about any changes from the daily meetings and via staff shift handovers. Staff could also access updates to people’s care electronically. A professional confirmed, guidance they provided was both documented and shared.

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 healthcare needs were met by the GP who held a weekly clinic and a podiatrist and optician visited people regularly. A person confirmed as they required assistance to attend an external appointment, staff had arranged the support required.

Staff had completed oral healthcare training and people’s oral health care needs were addressed within their care plan and people had access to a dentist.

Staff used nationally recognised tools to monitor people's health and to promptly identify and act upon any signs of deterioration.

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.

People's care plans detailed their planned outcomes in relation to their identified needs and guidance for staff about the person should be supported for outcomes to be achieved.

People's clinical outcomes were audited regularly to identify any areas which required action.

Staff were not all secure in their knowledge regarding when they should complete a Mental Capacity Act (MCA) 2005 assessment.

Staff had completed training on the MCA 2005 and those staff spoken with understood its purpose. A staff member said, “We would do a mental capacity assessment if there is a decision to be made and their [person’s] capacity is in question. You make a best interest decision discuss with other team members of your team, discuss with family.” Staff had access to the provider’s guidance.

However, staff on the nursing unit had completed mental capacity assessments for 2 people which were not required, as there was no reason to doubt their capacity to make decisions and they had already signed their consent. Staff had not recognised these assessments were not required. The registered manager took immediate action and arranged further staff training.