Leiston Old Abbey Residential 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 inspection we rated this key question good. At this inspection the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (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.

The registered manager told us people’s needs were assessed before they moved into the service, with the input of other professionals and the person. These assessments were used to inform the care plans. However, the care plans reviewed did not show these were being kept up to date with people’s changing needs and preferences. There were no documented care reviews which evidenced people and their relatives were consulted about their care.

A staff member told us they had resident of the day systems where people’s care was reviewed, and we saw in daily notes staff had updated care plans. However, we found the care plans were generic in parts, held outdated information, and/or had not been updated to show the current needs people had.

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

Without exception, we received positive feedback from people and relatives about the quality of the food provision. However, care records held contradictions. For example, a person’s records stated they had difficulty swallowing and they were prescribed thickener for their fluids, then also they were to be provided with thin fluids. Although staff told us the person refused to have the thickener, this was not explained in the care plan and any warning signs staff should be aware of if the person had regular fluids.

There was no information in care plans which identified the minimum recommended fluids people needed to reduce the risks of dehydration. There was no information in the care plans which included guidance for staff at what point they should be reporting to health professionals if a person had a low intake of fluid. A person’s care records stated they had recurrent urinary tract infections; there was no record of how to ensure the person had a baseline of fluids to reduce these risks.

People’s daily notes were not consistent in the ways people’s fluid intake was recorded, for example, some staff recorded the actual amount a person had to drink, others stated a cup of coffee, a hot drink or no fluids recorded at all. We did observe people being provided with drinks during our visits, however, the lack of consistent recording made it difficult for the provider to monitor if people were drinking enough to maintain good health and to reduce the risks of dehydration.

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.

The registered manager and staff told us they had good working relationships with other professionals involved in people’s care. However, we found people’s care records lacked information relating to if staff had received guidance from other professionals in how to support people to maintain their health. For example, a person’s care plan stated speech and language therapy team (SALT) were involved in their care, there was no date of this and no reference to any guidance received. Another person’s care plans stated they had a hospital stay due to bowel problems and were being monitored by a doctor, there was no date of this, what the issues were and what the current status was.

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.

People told us they had access to health professionals when needed. One person said, “The GP comes, I reckon about once a week.” A relative said, “The doctor has been to see [family member] when needed.”

However, people’s records did not include current information about people’s health needs and guidance for staff in the support they required to stay healthy. For example, a person’s care plan stated they sometimes had issues with their mouth. This was not explained such as what issues, when and what support they required. Another person’s records were contradictory about the support the person required with their oral health, the care plans stated they required full support and also staff were to pass their toothbrush to them.

People’s daily notes did not always show when people were supported with their oral care. For example, a person’s notes stated they were supported twice with their oral care in 17 days. This did not demonstrate people were being supported to maintain good health.

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.

There were some systems in place where, for example, daily notes had been reviewed by the registered manager in January 2026 and identified records did not demonstrate people were being supported with their personal care needs. However, there was no action plan in place, no timescales for improvement and we found these had been ineffective because in February and March 2026, the issue persisted.

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

We saw staff asked for people’s consent before providing any support. People confirmed staff did this routinely.

People’s records included information relating to their capacity to make their own decisions and where people lacked capacity, named individuals who could assist them to make decisions. However, the records did not detail the date of when best interest decisions had been made, when people lacked capacity, and when this was reviewed, to ensure the decisions were up to date. Where people had capacity to make their own decisions, the care plans did not demonstrate how people were consulted and included in the planning of their care.