Palm Court 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 requires improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

There was evidence to support that the breach of regulation in relation to person centred care we found at the previous inspection had been met.

This service scored 67 (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.

At the last inspection we found that people’s needs had not been regularly assessed and updated to ensure information was relevant and accurate. At this inspection we found that progress had been made and care plans mostly now reflected people’s current needs.

People’s care records had been reviewed regularly since July 2025, and this had ensured they were an accurate reflection of people’s health and care needs. However, whilst staff could tell us how they communicated with people and how they ensured their well being, there were documentary gaps in how this was achieved and monitored. This was being addressed. People's assessments included sufficient detail about their individual care needs and preferences, which had ensured their needs were met consistently and effectively.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Improvements have been made to the management of people’s nutritional needs. However, there was still a lack of choice for people. For example, on the day of the inspection, the midday meal was just one choice. We were told people could have fish fingers or jacket potatoes, but it was not clear how this was chosen as only the main meal was pictorial. This was discussed and a second main meal introduced in a pictorial format.

People’s weights were recorded, and the management kept an overview, and we saw evidence of appropriate referral when required. Referrals to other health professionals including speech and language therapists SALT were now clearly recorded in care plans.

Recognised risk assessment and monitoring tools were used appropriately to track improvements or concerns. These were integrated into the care plan system. The management team had oversight of these and planned action appropriately with the involvement of family and the staff team. The service had links with other organisations such as tissue viability services, occupational therapy team and SaLT.

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.

Care plans and risk assessments showed evidence of regular reviews that ensured they remained an accurate reflection of people’s needs. Staff ensured that entire care plans with associated risk assessments were sent with people when they moved between services.

The provider supported most people to manage their health and wellbeing to maximise their independence, choice and control. However, there were people on continued bedrest without a clear rationale documented or a best interest decision to support that decision. There was no evidence to say that it was their choice or that it was for medical reasons. This had the potential to impact on peoples’ independence outcomes. The manager confirmed that this will be reviewed.

There were systems and processes in place to guide staff on how to support people to lead healthier lives. People were encouraged by staff to eat healthy meals and drink regularly to maintain their physical health. A drink station had been introduced in the lounge that encouraged staff to offer drinks, along with snacks. Staff also went round the service with a trolley of snacks which included fruit. People were encouraged to walk and be active, and to take part in activities. We also saw staff sitting and reading with people to keep them stimulated.

Care documents showed there was evidence of regular reviews and input from the GP, Optician, Dentist and Chiropodist.

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.

Since the last inspection documentation relating to people’s needs had been regularly reviewed and updated. Care documentation now reflected people’s current care and support needs. Risk assessments identified current risks to people. Records relating to accidents, incidents and falls were now fully recorded and root core analysis completed. This meant opportunities to identify improvements to people’s care and lessons learned taken forward had been taken identified. Care plans and risk assessments had been updated to ensure people’s care was adapted and improved.

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

Whilst not all people could give verbal consent or had the capacity to make decisions, staff told us that they always asked the person and assumed they had capacity. Staff also told us, “If they refuse, we will not force, we wait and try again, sometimes a different staff member will try and that will work,” and “Never force anyone, it can be difficult if they change their mind when we have already started but we will stop and try again.”

A relative told us, “My relative can’t always give consent, but we have had meetings and discussed care and support, I don’t have any worries.”
Staff told us how they offered people choices in their daily care and demonstrated an understanding of people’s right to make their own decisions. Staff told us, “We always ask them first, dementia does change people, but we know it’s their illness and just take time.”

Improvements had been made to documentation to support people’s mental capacity status and decisions made in their best interest. Staff had received training in safeguarding and The Mental Capacity Act 2005 (MCA). The 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). The service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. The documentation supported that each DoLS application was decision specific for that person. For example, regarding restrictive practices such as locked doors and bedrails. We saw that the conditions of the DoLS had been met and reflected in peoples care plans.