The Star 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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. However, corrective action was implemented promptly by leaders.

This service scored 54 (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.

Care plans contained important information about people’s care and treatment.

However, care plans lacked personal details about people’s communication needs for example the impact of dementia on the way someone communicates.

Care plans lacked information about people’s likes and dislikes, preferences and what was important to them. Care plans lacked evidence that they were co-produced with the person and their family/advocates.

Care plans were missing important information in relation to end of life wishes, needs and preferences. People told us they were not always involved in the planning and reviewing of their care.

However, staff we spoke to knew people well and the provider had identified the need for care plans to be reviewed and had developed an action plan to improve the service.

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

The service did not always deliver people’s care and treatment in line with current national guidance and best practice. For example, diabetes management guidelines, pressure ulcer prevention and management guidance and recommendations for active mattress pressure settings. The service did not always identify risks to people to prevent a deterioration in their health and wellbeing. Two people who were at risk of weight loss were not having their weight monitored and pressure ulcer prevention measures had not always been followed for people who were at risk of skin breakdown.

However, care plans detailed clinical reviews and multi-disciplinary team input including collaboration with other professionals. For example, 1 person’s care plan recorded the multi-disciplinary review staff held with other professionals to consider options to improve someone’s mental wellbeing.

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.

We saw evidence of staff working with other teams involved in people’s care, for example, referrals made to health professionals following someone’s health deteriorating.

Important guidance and correspondence with other teams was in care plans. Care plans included a transfer to hospital document completed with essential information to help hospital staff understand the person’s needs.

Staff told us they felt there were effective communication systems in place for example the daily handover meetings. Staff told us they had good relationships with other professionals.

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.

In general people and their relatives felt they had good access to a GP and other services. One person told us, “Well they have a nurse here which is good. They will get a doctor out if they need to.”

We observed some activities that promoted physical activity for example balloon games.

However, care plans lacked person centred information on how health and wellbeing was promoted.

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 plans referred to outcomes but they were not person-centred. Care plans lacked information relating to people’s goals, wishes and achievements and did not focus on people’s strengths. We found that 2 people at risk of losing weight were not having their weight or food intake monitored regularly.

However, we saw evidence of multi-disciplinary reviews. We saw feedback from a social care professional and a family member who had seen positive health outcomes for people since moving to the home. One relative told us that the staff were good at adjusting their family member’s treatment when their needs changed.

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). Where necessary, mental capacity assessments were completed in line with the Mental Capacity Act 2005. DoLS authorisations and conditions were in place where required. However, we found care plans were not always updated with the outcome of DoLS referrals and whether conditions were in place.

Consent forms were in place however, it was not always clear who had provided the consent, who had been consulted and who had signed the document.

People told us that staff did not always seek their consent before providing support and people and their relatives told us they had not been involved in care planning or care reviews.