Newhey Manor Residential 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 consent.
 

This service scored 46 (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 was effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.
People’s care plans contained information about their care and support needs and limited information about people’s preferences. Reviews by the registered manager contained text that was copied and pasted each month and there was no evidence of ongoing involvement from people or relatives.
People’s care needs were not adequately assessed regarding diabetes management as blood glucose levels were not effectively monitored and in most cases not monitored at all. We fed this back to the registered manager who said the GP had advised they only need to be monitored every 3 months. However, there was no evidence or information in people’s care plans to support this.
A review of people’s care plans identified on-going reviews did not take into account all incidents and accidents that had occurred; changes in need were not always identified or acted upon.
The home manager told us they planned to hold one to ones with each family to capture information about their relative. However, this had not yet started, despite these issues being highlighted at our previous inspection several months ago.
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.
For people at risk of malnutrition, weights were recorded, however when a person’s weight had reduced there was no evidence of any action taken or discussions with the person or their families in response to this.
Food preferences were not always recorded and if people required a modified diet, to manage the risk of choking, care plans did not evidence people had been involved in planning the type of meals they preferred.
The relatives we spoke to were mainly positive about the food; one said, “(They) really enjoy the food and always tells me how nice it is when I ask.” However, we observed 2 people who did not want their meal and preferred an alternative. It was not clear whether the necessary support had been provided so people could make informed choices about their meals. One relative said, “We take (them) food in. (They do) eat the meals but they are a bit hit and miss with (them)."
Staff supported people who required assistance to eat their meals. Half of the people who were in the lounge at the mealtime remained in the lounge with tables drawn up to their chairs. We did not observe any of the staff asking if they would like to go into the dining room and these preferences were not recorded in their care plans.
 

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.
A new home manager had been recruited since our last inspection. While some tasks had been delegated, the registered manager still undertook the majority of managerial tasks including reviewing care plans, some of which contained information which was not reflective of people’s current needs. Some senior staff had expressed to the registered manager that they felt they were not achieving their full potential in their roles.
Staff worked with other health care professionals to help meet people’s needs. The service sought advice and support from the local GP when needed and we saw evidence of referrals to the Bladder and Bowel team. A physiotherapist also visited the home on a weekly basis.
Daily flash meetings had been introduced since our last inspection which provided an opportunity for updates about people to be shared between staff.
 

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.
Accurate and complete records were not maintained in relation to people’s current and changing needs. This information would help to quickly identify where additional support maybe required.
There was little opportunity for physical activity and people rarely left the home, unless it was with a relative or friend. There was no activity worker on site and staff were busy dealing with care tasks and there were limited activities provided. This was raised at the last inspection and opportunities still needed exploring, taking into consideration people’s hobbies and interests, particularly for people with dementia.
People spent the large majority of their time sat in the same area with little stimulation. Daily care and support needs were met and people received the support from other healthcare professionals when required
 

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.
Care delivery and staff practices were not always aligned to people’s care records which meant there were missed opportunities to improve people’s everyday lives. For example, one person had been given a series of exercises from the physiotherapy team, to help improve their mobility following a stay in hospital. Staff did not assist this person to walk around the home during this assessment, which limited any potential improvement. We were advised that this person now received physiotherapy sessions weekly within the home, however no other improvements could be seen.
 

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.
Staff received training in the Mental Capacity Act. The service was working within the principles of the MCA. Capacity assessments and best interest decisions in people’s care plans had not been completed accurately and had large amounts of information missing. This meant we could not be assured that decisions were always being made in line with people’s best interests.
People’s care plans stated that consent had not been given for photos, care provision or sharing information with healthcare providers. Consent forms were missing from people’s care plans, so we were not assured that consent decisions were being managed and followed correctly for people who had capacity and those who lacked capacity

In addition, there were concerns raised during the inspection about a person with capacity being restricted unlawfully in regard to their alcohol consumption. This was discussed at length with the registered manager, and we were not assured that the necessary changes would be made.