Shawford Springs 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.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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.

Staff told us that in the main, people were reviewed face to face prior to moving to the service. Some people moved to the service long term, while others moved there for respite following a stay in hospital for example. One person said, “They were ever so good when they came to the hospital, after I'd had my [health issue], and we talked all about what I needed.” Staff told us they were informed about people’s needs via handover and by reading care plans. One staff member said, “Any new residents are discussed at our daily meetings. They will have had a pre-assessment, and we re-assess them when they come in to make sure the plan is up to date.”

People’s needs were reassessed regularly; in the main, people’s relatives told us they were invited to these reviews. If the management team felt the service was no longer able to meet people’s needs, this was discussed with family members, and they were supported to find suitable alternative placements.

The registered manager said, “The pre-assessment is a snapshot in time. This is people’s home so I need to assess if we can meet new resident’s needs and if they will fit in. I will speak to our other [nursing] homes and get some feedback from them. If we can’t meet people’s needs here, then we can suggest one of our other homes if that works.”

One health professional said, “They have had a couple of residents whose needs they couldn’t meet. They spoke to the family about moving and I agreed with them it was the right thing. I think it's a good thing that they realised they couldn’t meet the person's needs safely there.”

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.

The provider used nationally recognised tools to assess and monitor people’s needs and risks, including the risk of malnutrition and skin damage. Staff working at the service understood the importance of good nutrition and fluid intake for people and staff supported people with this where required. People’s relatives told us their loved ones had experienced positive weight gain since being supported by the service. One relative said, “[Name] is gaining weight and is weighed regularly and they're also monitoring the fluid as well as the food intake.”

Kitchen staff were aware of people’s dietary needs and preferences. The cook told us, “Last week we had chicken Caesar salad on the menu, but one person doesn’t like meat, so I offered tuna instead and [name] was so happy. If they don’t like what’s on the menu, I will make something else. I don’t like to say no to anyone. Another person likes pasta but not with tomatoes, so I do one with pesto for them instead.”

We observed lunch on both days of the inspection. It was a sociable experience with people encouraged to eat with others in the dining rooms. In the main, people told us they enjoyed the food. One person said, “The food is very good overall. At every meal there is always one thing that I particularly like. And lunch is a sociable occasion; we can have a glass of wine and a chat.” One person told us they were not very satisfied with some of the menu options. The management team and chef were aware of this and had arranged for a tasting session for this person so that they could be provided with food they enjoyed.

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 had access to people’s care and support plans to understand people’s needs and deliver their care. There were weekly visits from the local GP surgery and the service was also supported by the community nursing team. Health professionals we spoke with told us the staff were proactive in making contact for advice and followed any recommendations. One health professional said, “We do ‘shared care’ with them; so, if there is a skin tear or a category 1 wound for example, the staff do the assessment and take some photos and send them to us. We then tell them what to do and they send us photo updates weekly. It works well.”

People told us staff contacted the GP for advice if they were unwell. One person said, “They [staff] make appointments for me to see the podiatrist, and I've just had blood tests done which were my usual ones that I have every year. It’s all very efficient. If I had family living nearby, they could take me but the home help me get to my appointments.”

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.

Staff monitored people’s health and escalated concerns appropriately. One health professional told us, “The staff know people really well here. They have good connections here with all the residents. The staff are excellent, are always prepared and have the care plans accessible when I come. If they have concerns about someone’s health, they will do observations and follow through with us. They complete the [National Early Warning Score tools]. They keep a record on the system, so if I ask, they can show me.” National early warning score tools help healthcare professionals determine the urgency and scale of a clinical response based on a patient's physiological measurements.

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.

There was oversight of people’s needs in place. Records showed that wounds, weight loss and falls for example were monitored and analysed. People’s relatives told us their loved ones “looks healthy” and “has maintained weight.” Appropriate referrals had been made for people who required additional clinical support, such as the tissue viability nurse, the older people’s mental health team and speech and language therapy (SALT). The service was supported by the providers clinical development nurse. They told us, “[Deputy Manager] will always send me clinical analysis and I review it and give clinical input where needed. For example, I might offer suggestions as to whether it would be a good idea to refer to the OT or to the nutritionist. We all work as a team, and it really works.”

The GP carried out weekly reviews. They told us, “With any choking concerns for example, the staff flag it to us, and we do a referral onward. They [staff] flag to us if people lose weight, or if the MUST score (a malnutrition risk assessment) is increasing for example.”

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

Overall, people told us staff asked for their consent before supporting them and respected their choices. We saw and heard staff asking people’s consent before they supported them. For example, we observed staff knocking on bedroom doors and waiting for a response before entering. One person’s relative told us, “The carers ask [relative’s] permission. For example, yesterday when I was there and [relative] needed help with moving, they checked that [relative] was aware of what they were about to do and ensured that [relative] was comfortable with everything.” Staff had received training in mental capacity and consent. All staff we spoke with described how they ensured people were able to make choices about their care and support. One staff member said, “I think it’s important to have accountability for what we do. If a resident can’t communicate, we still ask for consent; for example, one resident can write yes or no. It’s important to always ask consent because at the end of the day, it’s their choice. Some female residents don’t want male carers, and we have to respect that.”

Mental Capacity assessments had been carried out in line with legislation. 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 Mental Capacity Act 2005 (MCA). In care services, 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. All legal applications had been made in accordance with DoLS. This meant people’s rights were fully respected. The registered manager kept a record and tracker of DoLS applications and authorisations.