Seven Arches Nursing 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 63 (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 they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Whilst most people had evidence of pre-assessment information, as discussed in safe systems and pathways section, 1 recently admitted person’s care needs had not been fully explored prior to admission.

People’s care, support and communication needs had been assessed and recorded within their care plans.

The registered manager told us they carried out daily walk rounds and delivered people’s care to ensure people’s care and treatment was effective. Care plans were reviewed regularly by staff.

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.

People and relatives, we spoke with were happy with the food and told us they received a choice. Most people we spoke with told us the food was good with a relative adding, “The meals are absolutely lovely, I have been provided with lunch before, and they catered for my special diet. Considering I am a relative I thought this was very good. They also know I like hot chocolate and often make me one. It’s fish and chips every Friday.”

The meal experience was positive with plenty of staff available to assist people to eat when required. We observed people’s food was plated and served and whilst staff told us people had selected their choice prior to the meal, 1 person told us they did not like tartar sauce which had been put on their plate. The staff quickly removed this, but more work was needed to ensure some choices could be offered at the time of the meal particularly for people living with dementia. People were offered a choice of drinks and condiments were available for people to use. Staff supported people in a kindly and unrushed way.

Care plans contained evidence of involvement of a range of external professionals. Referrals were made to dietitians when people had lost weight and the speech and language team when people required modified diets.

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.

People received care and support from a consistent staff team who knew people well. Care plans contained evidence of other visiting professionals and the outcome of their visit.

A professional told us, “The staff show an adequate skill level to perform the wound care asked of them. They know to and are comfortable in asking for reviews and input. They communicate with the service well via email, as well as calling our contact number.”

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 had access to healthcare when this was needed. The registered manager told us they had good relationships with visiting professionals and were able to contact them quickly when people needed this. Weights were monitored carefully to ensure action was taken when needed.

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 andconsistent, or that they met both clinical expectations and the expectations of people themselves.

Improvements were needed to some monitoring charts as stated in the risk section. The registered manager told us the electronic care plan system had an artificial intelligence function which they would use going forward to monitor charts more effectively.

The registered manager also gave us examples of how people had improved since their discharge from hospital. This included a person admitted to the service who was unable to mobilise, staff had encouraged them to stand and walk resulting in a positive outcome as the person was transferred to a residential care home.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The Mental Capacity Act 2005 [MCA] provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards [DoLS].

We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met.

Mental capacity assessments were in place; however, they were not always decision specific. We found some restrictive practices such as bedrails and alert mats were grouped together but these required individual assessments to ensure all least restrictive options had been considered.

Consents to people’s care and support was not always in place. Communal CCTV was in place and whilst signage was displayed and the registered manager told us people and relatives were informed, there were no formal consents for this.

People and relatives told us staff asked for consent day to day. A person told us, “It is my choice to be in my room.”

Staff had received training on the principles of the MCA and understood how to apply this in their day-to-day practice. A staff member told us, “We make sure people can choose what they want to wear or eat.” Another staff member said, “The Mental Capacity Act ensures that individuals who may lack capacity are still supported to make their own decisions where possible.”