Charnwood Care Home

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• 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 inadequate. At this assessment the rating has changed to 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. People’s needs were now holistically assessed. Care plans were detailed, and people and their relatives were involved in care planning. A relative we spoke with said, “I know my [relative’s] care plan well and have had reviews.” People had their needs fully assessed prior to moving to Charnwood, this meant staff had guidance in order to support people safely.

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. A wide range of national risk assessments were in use to ensure any risks were identified using best practice guidance. For example, a nationally recognised wound assessment tool was utilised to identify people at risk of pressure damage, a nutritional risk assessment tool was used to highlight people at risk of malnutrition. The use of tools identifies areas of risk and provides guidance to staff to provide effective care.

The management team worked well across teams and services to support people. They created assessments of people’s needs when they moved between different services, so people only needed to tell their story once. Care plans were person centred and focused on people’s clinical needs. We found where specialist input was required their guidance had been embedded within care plans. People said, “Staff are very good at speaking to others for me, I had my eyes checked by the optician and the chiropodist comes, the staff organise all that for me.” We found where people required assessments from external healthcare professionals prompt referrals were made. For example, referral to the community nursing team were made without delay. We received feedback from a healthcare professional who said, “Staff are friendly and welcoming, they have made lots of improvements and are keen to keep making those improvements.”

People told us staff supported them to access health appointments when needed. People and their relatives told us staff recognised changes to their health needs and supported them to gain access to healthcare professionals. For example, a person said, “The staff are very good, they notice if I’m not myself and call the GP.” Records were kept of when health professionals visited people, and what advice they gave. For example, we reviewed a care plan with guidance from the tissue viability nursing team in regard to a person’s wound care. We found staff monitored and support the person in line with the guidance from the specialist team. Staff recorded people’s daily wellbeing. This allowed staff to monitor the people’s overall well-being. For example, staff recorded people’s daily food and fluid intake where they were at risk of malnutrition. Where needed people were referred to the nutritional team for dietary support. This protected people from the risk of malnutrition.

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.

Meaningful monthly care plan reviews ensured the management team had effective oversight of the needs of all people. Processes in place meant the registered manager and management team had good oversight of people’s care and support. Care plan audits were completed to review and monitor people’s progress. Where concerns were identified action was taken. The electronic system meant when changes were needed these were made without delay. This meant staff had accurate information to support people effectively. People and their relatives were involved in their care, people were supported to maintain their independence. A person we spoke with said, “I stay in the lounge from choice but go to bed or have a nap when I want. I decide things for me, they never force you to do anything, the activities, I just like to watch, and they never try and force me to do anything but watch.” The provider sought the opinions of people and their relatives carrying out monthly meetings, the registered manager also held weekly open clinics for people to raise any concerns or share ideas. A person told us, “They get us together in the lounge, and ask us what we think about things.” A relative we spoke with said, “They send the minutes out even when I don’t attend.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff had completed further training since out last assessment regarding the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making 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 make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Where people lacked capacity mental capacity assessments had now been completed in line with the legal framework. Some people at the service were subject to a Deprivation of Liberty Safeguard (DoLs), this is where the person cannot make decisions about their care and treatment. So restrictive care arrangements are legally authorised in the person’s best interest. Staff had a good knowledge of DoLs and how this impacted people. We found conditions attached to authorisations were complied with and clearly detailed in people’s care records. People told us staff always asked for consent before providing support, a person said, “They make sure I’m happy and safe before they do anything.” Our observations supported this feedback, we observed staff to continually ask for consent before providing support.