The New Wycliffe 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.

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.

At the time of the inspection, people’s care plans were being reviewed and rewritten. As recorded in the Safe key question, we were concerned about the time taken to complete this action and the lack of a coordinated approach with regards to prioritising assessed needs.

We reviewed a sample of updated care plans and found these were overall well completed, detailing people’s health conditions and how this impacted the person. Staff were provided with guidance of how to meet people’s care needs and actions if concerns were identified. Information was person centred, and independence, choice, dignity, and respect embedded.

However, we identified some shortfalls and inconsistencies in the level of detail recorded, we shared this with the manager who agreed to address. For example, a person’s catheter care plan dated July 2025 did not include guidance for staff about recording fluid input and output. National Institute for Health and Care Excellence (NICE) guidance recommends recording fluid input and output is a crucial aspect of catheter care. We discussed catheter care with staff, and they confirmed fluid input and output was monitored,

A person had diabetes and another person a kidney condition. Both these health conditions meant hydration was a key factor in keeping them well. However, guidance did not include what the optimum amount of daily fluid intake should be. Other examples of the same or similar health needs recorded this information. This inconsistency could have a negative impact on people’s health and wellbeing.

Another person’s care plans dated April 2025 recorded how the person was able to walk short distances using a walking frame. However, the person was no longer walking independently. We were aware the service used agency staff at times and new staff were continually being recruited, the recording of accurate information about people’s care needs and guidance for staff was essential in ensuring people received effective care.

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

There was a lack of involvement with people and their relative and or representative about how people’s care needs were met. A reoccurring concern raised by relatives was about communication and involvement in how people’s care needs were met. A relative said, “There doesn't seem to be a review regarding my relatives care support, it would be nice to have one rather than having to keep raising things when I visit.” The manager acknowledged this and told us of the plans to make improvements, such as implementing formal review meetings to include people and their relative and or representative.

We observed people’s mealtime experience and found improvements were required. People did not have a positive experience. Concerns were identified about the numbers of staff available to meet people’s support needs effectively, ensuring food intake was the optimum it could be.

At the time of the inspection, improvements were being made and were ongoing in relation to people’s care plans. These were being reviewed and updated to ensure they were reflective of people’s current care needs including their routines, preferences and what was important to them. From a sample of care plans reviewed, dietary needs, including cultural needs, and preferences were assessed and planned for.

Information for kitchen staff was available to inform them of people’s individual dietary needs, any risks and preferences. We found this information was not fully accurate and reflective of current needs and included people no longer living at the service. We raised this with the manager who immediately amended the information. We found staff were aware of people’s dietary needs.

The menu was based on feedback received from people and was reviewed and changed periodically. The food standards agency gave a 3 star rating in May 2025, meaning improvements were required in food safety practice. We found these improvements had been made.

People had a choice of menu and drinks and snacks were available throughout the day and evening. Where people were at risk of malnutrition, this was known and planned for. For example, foods were fortified to add calorific value, people were supported with their prescribed food supplements and weight, food and fluid intakes were recorded and monitored. Where concerns had been identified about weight loss this had been reported to the GP.

The provider used a number of clinical assessment tools to support them in providing the care required to meet care needs such as skin care, mobility, and malnutrition. These needs were monitored and any gaps identified were raised with staff to make improvements.

The provider’s policies were found to be up to date and reflective of current best practice and legislation.

The provider did not always work well across teams and services to support people.

Improvements in how staff worked together, including with external health and social care professionals had been made and was ongoing. Further time was required for improved ways of working to become fully embedded and sustained.

Since the provider took over the service from the previous provider, we had received high levels of concerns raised with us about how the service was being managed. Under the leadership of the current manager we have received less concerns. Staff told us working relationships had started to improve. The manager told us of their ongoing actions to make improvements and was open and honest about the difficulties they had experienced, but felt confident improvements had been made and recognised further work was required.

External professionals told us an area of concern they had experienced was in relation to communication with the service. Examples were given about care staff not being able to share important information about people’s health needs, to support them in making clinical decisions, that may impact people. However, they told us this was an area of recent improvement.

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.

Health care needs were not consistently and effectively managed. A reoccurring concern raised by some relatives was in relation to how healthcare needs were managed. A relative said, “I seem to be having to chase things up to get information rather than them [staff] being proactive.” This relative told us of a recent hospital admission their relation had experienced. The relative was concerned there had been no discussion with the staff about the hospital’s diagnosis. In particular, the person had experienced a DVT (Deep vein thrombosis) a serious medical condition that can be life threatening. The person had no care plan or risk assessment in relation to this heath condition. We discussed this with the manager who checked the person’s hospital discharge letter that included this information. The manager took immediate action, and a care plan and risk assessment were completed. The provider’s hospital discharge procedure was also reviewed and amended to ensure this lack of oversight was not repeated.

A person told us how they were supported to attend outpatient appointments. They said, “I tell staff of my appointments, and they organise it, so someone takes me. Any problems with my health I tell the staff, and they got the doctor if needed.”

Another relative told us they had experienced recent improvements in how their relation’s health needs were monitored an acted upon. They said, “[Relation] is prone to reoccurring chest infections. In the last 6 months I found that staff are more aware of when they are developing an infection and staff inform us if the doctor has been and antibiotics have been prescribed.”

External professionals told us they had experienced occasions when advice during consultations were not always followed up on, and how people were often reviewed a number of times with the same issue. They also raised concerns about the provider’s internal communication systems that shared information with staff relating to people’s health care needs. They told us they found staff were not always aware of health changes.

At the time of the inspection, improvements were being made and was ongoing in ensuring staff had up to date guidance about how to meet people’s healthcare needs. The GP or their healthcare representative attended the service weekly.

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.

As already referenced in this report, we were aware the provider was taking action to update people’s care plans to ensure staff had up to date and detailed guidance of people’s current care needs. However, we were concerned of the timescale and approach and were not sufficiently assured people had experienced consistent positive outcomes.

The provider’s electronic records system alerted the management team of any care interventions that had not been completed or if people had not had enough to eat or drink.This was monitored daily, and any concerns were raised directly with staff and reported to the senior leadership team. Overall, we found these records to confirm people’s care needs were being met. However, we also identified some shortfalls such as people not always having received sufficient hydration or having been repositioned at the frequency they had been assessed as required. We saw that this had been identified by these monitoring systems and addressed.

External professionals raised concerns about care staff’s understanding and competency about dementia care. The manager was aware of this and told us of some recent additional dementia care training staff had completed. Further actions were being taken to enhance and upskill staff. This included Positive Behaviour Support training, a recognised care approach in dementia care. Also, Dementia Care Mapping, a person centred approach that uses direct observations to assess the quality of care and life for individuals with dementia.

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) was not fully adhered to. In May 2025 we were alerted to the use of surveillance (CCTV- close circuit television and audio recording). We forwarded the provider information relating to this, including what we expect from providers to be compliant. This included applying the MCA if people lacked mental capacity to consent to this. At the time of the inspection, not all MCA assessments and best interest decisions had been completed. The manager told us they were in the process of completing further MCA assessments.

From reviewing a sample of care records, we saw examples of completed MCA assessments and best interest decisions, and these were well completed. However, we also identified examples of missing MCA assessments and best interest decisions where these were required.

Staff had received training on the Mental Capacity Act (MCA) and whilst they had some understanding of the principles the MCA, this was limited. For example a staff member said, “We let people make their own choices where they can, and where they can't we make best interest decisions.”

Where people had DNACPR (do not attempt cardiopulmonary resuscitation) or advanced decisions about their care and treatment, this was known and recorded and staff had access to this information to share with others such as ambulance staff