The Rookery 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.At our last assessment we rated this key question requires improvement. At this assessment, the rating has remained 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 58 (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 was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

Care plans were detailed and personalised and staff knew how to access them. These contained relevant information about people’s histories, preferences, and clinical needs. However, some risks in the building had not been assessed. For example, there was a gate at the bottom of the stairs to stop people going upstairs unaided and fall, but there was no gate at the top of the stairs. The registered manager told us the door was closed at night, but this did not consider the risk during the day, and some people had chosen to stay in their room upstairs. As there were many people within the home who were at risk of falls, some of which independently mobilised around the home, this was a risk to their safety and had not been identified in their care plans or risk assessments when assessing their needs.

For people living with dementia or with communication difficulties, care plans did not consistently explore how these needs affected daily living or how staff should adapt their approach. Although staff knew people well in practice, this knowledge was not routinely reflected in written care plans which limited the provider’s ability to ensure consistent, person-centred support across the whole staff team.

While there were examples of good practice, inconsistencies in quality and oversight meant people did not always receive care based on a complete understanding of their individual needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, this was not always done in line with legislation and current evidence-based good practice and standards.

People’s needs were assessed using recognised tools such as the Waterlow Scale and the Malnutrition Universal Screening Tool (MUST), which helped identify risks such as skin breakdown or poor nutritional intake. Pressure relieving mattresses were in place where required, although at the time of the assessment no one needed strict repositioning support, therefore this was not something available to review.

However, the way evidence-based assessments were recorded and monitored was inconsistent. Daily logs included general statements about food, nutrition, and personal care, but did not contain meaningful detail. For example, one entry simply stated, “ate and drank well,” which did not provide information about how much a person had eaten or whether their intake was adequate. This meant staff did not always have the information needed to identify early signs of malnutrition or respond promptly to emerging health concerns.

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.

During the assessment we observed staff working in partnership with external professionals such as district nurses to support people’s needs. Staff worked well with external professionals to ensure transitions were well coordinated and planned in line with people preferences. The management team worked closely with health and social care professionals to ensure people’s needs were met.

This meant people received coordinated care from teams who communicated well and worked together effectively.

The provider did not always support people to manage their health and wellbeing to maximise their independence, choice, and control. Staff did support people to live healthier lives and, where possible, reduce their future care needs, but this was not always well documented.

People had access to activities which promoted their wellbeing, and staff encouraged engagement in ways that reflected people’s preferences. People were also offered variations in food where needed, such as low‑sugar or low‑calorie options, to support diabetes and weight management. These approaches demonstrated an awareness of people’s individual health needs.

Staff recognised the link between mental wellbeing and people being empowered to achieve goals and participate in meaningful activity. One staff member told us, “We do daily activities and they do games and things like that. If they don't want to do that we will see if they want to watch a film or read a book or newspaper, making sure they are still encouraged to stay stimulated. Pretty much everyone joins in.”

However, daily notes contained limited detail, and the service had not considered dementia‑friendly measures which would enable people to be as independent as possible within their daily routines. The absence of such environmental adjustments meant opportunities to promote healthier, more independent living were sometimes missed.

This meant that whilst people were encouraged and supported to improve their health and wellbeing in ways that mattered to them, the lack of consistent documentation, environmental consideration and structured oversight, limited the provider’s ability to ensure people were always supported to live healthier lives in a safe, proactive and well‑coordinated manner.

The provider did not always routinelymonitorpeople’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.

Daily records often lacked the detail needed to identify changes in people’s needs. Entries such as general statements about food intake, mobility or mood meant staff did not always have reliable information to recognise early declines in health or wellbeing. This limited the service’s ability to respond quickly or adapt care in line with people’s changing circumstances.

Audits were in place but were not consistently effective, as gaps in record keeping, monitoring charts and assessment accuracy were not identified through internal checks. This meant the provider lacked reliable oversight of whether people’s outcomes were improving or if they were at risk of deterioration. Although people told us staff supported them well, without systematic and reliable monitoring the provider could not be assured improvements were consistent or that everyone experienced outcomes that met both clinical expectations and their own preferences.

The provider told people about their rights around consent and respected these when delivering person-centred 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's capacity was assessed in line with the MCA and, where people did not have capacity, decisions were made in their best interest.

We checked whether the service was working within the principles of the Mental Capacity Act (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. We found the provider and staff worked within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

People had care plans which documented they and or their families had been included regarding their capacity and best interests. This meant people's rights were respected and upheld, ensuring they received care and treatment in line with their individual needs, preferences, and legal protections.