Lakeside Watermead 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, following a change in provider. 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.

The service was in breach of legal regulations in relation to assessing consent under the Mental Capacity Act 2005.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Systems were in place to ensure that people admitted to the service were assessed to ensure their needs were identified and met.

The service had recently moved to electronic care records. Those records were still under development. They included a range of assessment tools such as a malnutrition universal screening tool (MUST) and waterlow score to assess pressure ulcer risk to ensure people’s needs are reflected and understood.

People and their families were being encouraged to be involved in care planning to promote their views and maximise their involvement. A ‘resident of the day’ process had been introduced to promote regular reviews of people’s care.

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

We identified concerns with the recording of mitigation of risks associated with dehydration, and malnutrition. However, the provider assured us of the actions they were taking to rectify these.

We received mixed feedback on the meals. Some people told us they had a good choice of meals and were happy with the meals provided. We saw one person was not provided with a balanced and nutritious meal at lunchtime. Following the inspection the provider confirmed the actions agreed to ensure the person was provided with suitable nutritious meals.

The provider mostly 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.

The provider had systems in place to ensure information was shared with team members to ensure people’s needs were met. Whilst some changes to people’s circumstances and ways to improve care were discussed at handovers, daily ‘flash’ meetings, staff meetings or weekly clinical meetings, we saw not all key information on people was communicated such as accidents to promote safe care.

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.

People’s care plans outlined their medical conditions. Whilst some were detailed and specific around diabetes and epilepsy, we found the care plans on Parkinson’s were generic as opposed to outlining how the Parkison’s impacted the person.

The service worked closely with health professionals such as to the fall’s clinic and tissue viability nurse. Weekly GP rounds took place to ensure changes in people’s health was monitored and managed. They used Telemeds which is a service available to care homes and provides virtual consultations with GPs and healthcare professionals via secure video and phone platforms to promote timely access to specialist advice and escalation to health professionals as required.

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.

The provider had introduced a ‘resident of the day process’, with a schedule in place to ensure each person was included in the process. This enabled them to ensure continuous improvements were made to people’s care and treatment. During ‘resident of the day’ a care review took place which included an audit of the person’s medicines. People’s involvement with activities and food preferences were reviewed, and their bedroom was cleaned and any maintenance issues identified and addressed. This process was still being developed and monitored to ensure staff were clear of their responsibilities in relation to the process.

We found some care plans were not reviewed and updated in response to changes in people. For example, in relation to an increase in falls, fluid monitoring, arrangements around money management and changes in people’s needs were not updated. The provider acted on our feedback to make the required changes to care plans and reinforced to staff the process and importance of keeping people’s care under review.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment and they failed to work to the principles of the Mental Capacity Act 2005.

Staff responsible for completing assessments were trained in the Mental Capacity Act 2005. However, they failed to complete decision specific mental capacity assessments and best interest decision meeting records for people who required them.

We identified concerns with conflicting information regarding a person being assessed as lacking capacity, we found some people had decisions made on their behalf without evidence of mental capacity assessments or best interest decisions being completed. In response to our feedback the provider implemented changes to ensure information was correct and menatal capacity assessments were in place.