Haywood Oaks 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 good. At this assessment the rating has changed to 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 regulation in relation to people’s safe care which included care planning and record keeping.

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 were effective because they did not consistently check and discuss people’s health, care, wellbeing and communication needs with them. Care plans did not always contain clear guidance for staff on how people wished to be supported.

Care plans lacked sufficient detail to guide staff practice when people’s preferences changed. For example, one person required regular repositioning and had an extension fitted to their bed to allow their legs to be safely elevated. However, there was no guidance for staff on how to support this person when they chose not to sleep in their bed. Records completed by staff did not evidence that they had supported the person to reposition or elevate their legs when they were seated in a chair, which was the person’s preference.

People and relatives told us they were not always involved in care plan reviews. One relative said, “They [staff] phone with updates, but I don’t think we have ever reviewed the care plan together.” This meant the provider could not always demonstrate that assessments and reviews were person‑centred, inclusive or reflective of people’s choices and changing needs.

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

Care plans did not reflect clear or evidence‑based guidance. For example, one person required their drinks to be thickened to mitigate the risk of choking. However, the care plan contained three different dosage amounts for thickener administration. This inconsistency placed the person at risk of unsafe care. In addition, records staff completed such as daily notes and fluid charts did not consistently show that thickener had been administered to drinks. This meant the provider could not be assured that fluids were always provided safely or in line with the guidance intended to reduce the risk of choking.

The provider worked well across teams and services to support people. Care plans showed where professionals had been involved this had been recorded. Where people requested to see a medical professional such as a GP or dentist, record showed these appointments had been made and the person supported to attended.

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.

For example, one person living with dementia was given a meal at lunchtime. The meal remained uneaten and was removed after 2 hours. Staff had not provided prompting, encouragement or support to help the person eat. This demonstrated a lack of responsive support to meet the person’s nutritional needs. Additionally, care notes recorded by staff 30 minutes after the meal had been served stated that the person had eaten all of their meal. This conflicted with what was observed and meant records were inaccurate. This meant the provider could not be assured that the person was being supported safely or effectively with their nutritional health.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not consistently ensure outcomes were positive, effective or met both clinical expectations and the expectations of people themselves.

Some people required daily fluid intake monitoring to ensure they received enough fluids. However, these records were not completed consistently. There were days where no fluid records had been completed, and on other occasions people had not met their daily fluid targets without evidence of action, review or escalation.

There was no clear documentation to demonstrate concerns had been escalated to senior staff or healthcare professionals when people repeatedly failed to meet their hydration targets. One relative raised a concern and told us, “[Relative] has had an ongoing urinary tract infection; the doctor has said it could be related to dehydration, so I am concerned they are not getting enough to drink.” This indicated outcomes were not always effectively monitored or improved when risks were identified.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Observations throughout the assessment showed staff checking in with people before offering support, explaining what they were doing and waiting for clear indications of consent before proceeding. This included using simple language where appropriate or giving people additional time to process information when needed.