Alderbrook 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 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 50 (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.

Although assessments were completed in relation to people’s needs, and these generally contained relevant information, some lacked essential detail. The meant information in care plans was not comprehensive enough and provided insufficient guidance about how staff should support people with behaviours of anxiety and their individual communication needs. This meant staff did not always have the necessary guidance to deliver consistent, safe, and appropriate care.

These gaps in assessment and planning resulted in staff relying on their own judgement rather than informed guidance, increasing the risk that care provided did not meet people’s needs, preferences, or best interests. People and their relatives were not always meaningfully involved in the development or review of their care plans. One person told us they had requested that their care plan be reviewed, but no action had been taken.

Overall, the provider did not always ensure that assessment processes were robust, ‑person-centred, or inclusive, which limited the service’s ability to make sure people received effective and well-planned‑ care and support.

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

There were several people who were experiencing weight loss, and although the management team told us that actions were being taken to monitor and aid nutritional intake, these actions were not always captured or recorded in a way that provided clear oversight or assurance. This limited the provider’s ability to monitor people’s nutritional intake appropriately.

Feedback about the quality of meals was mixed. Some people expressed dissatisfaction with the food, describing it as basic or repetitive, while others reported that meals were good with alternative options being available. At lunchtime we observed food that appeared appetising. However, the mealtime experience was disorganised and did not support safe or person-centred care. Staff were not always aware of who they were responsible for supporting, and this disorganisation led to people not always being offered meals or having meals removed before they had finished. One person’s lunch was taken away while they were assisted to the toilet and not reoffered on their return. Another person told us they had missed their evening meal because they had remained in their room and not attended the dining room as they usually would.

Overall, the provider did not consistently ensure that care and treatment was delivered in line with evidence-based standards or best practice principles. The lack of mealtime organisation, nutritional oversight and communication between staff undermined the effectiveness of care and increased the risk that people’s needs and preferences may not be met, this was immediatelyacknowledged by the management team who took action to improve organisation during mealtimes and record keeping particularly in relation to people food and fluid intake.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. We found instances where individual staff made decisions about people’s care without ensuring these were communicated to the wider team, including managers. This meant that important changes or actions were not always understood or implemented consistently.

Staff were aware of how to make referrals to health professionals, and we saw evidence of external professional input within care records. Handovers took place and the interim manager had begun to improve handover documentation at the time of the assessment. However, these improvements were not yet fully embedded and did not mitigate the lack of consistent teamwork and communication within the staff team.

Overall, the provider did not ensure that staff worked collaboratively or shared essential information reliably, which limited the service’s ability to provide joined up‑, safe, and effective care.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice, and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Care records showed that referrals were made to appropriate health professionals, including GPs, district nurses, opticians, and dentists. However, there was no evidence that people, or their relatives where appropriate, had always been consulted or involved in these decisions.

Staff did not always promote or maintain people’s mobility. We observed staff encouraging people to sit rather than walk, which limited opportunities for individuals to retain mobility and benefit from physical activity.

Feedback about people’s health support was mixed. One person told us they received regular visits from healthcare professionals, including the mental health team. A relative reported that their family member saw the chiropodist and audiologist; however, the person also told us that their hearing aids were not always charged as required, leaving them at risk of isolation due to reduced communication.

Overall, the provider did not always ensure that people were supported in ways that maximised their health, wellbeing, or independence. The lack of consistent involvement, proactive support, and promotion of healthy living limited people’s opportunities to achieve good outcomes.

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.

There was poor oversight of care records and assessments, and the electronic care planning system was not being used effectively to ensure people’s needs and planned outcomes were met. Staff and managers were unable to reliably access or review key information needed to evaluate whether care was being delivered as planned. The interim manager told us they were unable to “drill down” into the system to gain assurance that required tasks had been completed, which significantly limited the provider’s ability to oversee people’s care and identify emerging risks.

Overall, the provider did not operate robust monitoring or review processes. The lack of systematic oversight meant shortfalls in care delivery were not always identified or addressed, reducing the provider’s ability to support consistent, person-centred outcomes for people using the service.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Where people lacked capacity to make decisions about their care and support, the principles of the Mental Capacity Act were not always followed. We found examples where best interest decision making processes had not been completed. For instance, one person did not have any documentation in place to show that the use of a sensor mat and bed sides had been appropriately assessed as being in their best interests, despite these measures restricting the individual’s freedom of movement.

Some care plans relating to mental capacity included good detail about fluctuating capacity and provided guidance on how to support people to make decisions. However, this was not consistent across the service. Other care plans lacked sufficient information to enable staff to understand how to support people to express choices or participate in decision making. Overall, there was a lack of recorded evidence about how people’s consent was obtained or how people’s rights and preferences were consistently considered when planning or delivering care.This meant people were at risk of receiving care that did not align with their wishes or best interests. It is important to note that people were being supported appropriately the issue was regarding appropriate documentation not always being in place.