Wrenbury Nursing 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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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.

Staff undertook assessments of people’s needs before people moved to the home. They used various assessment tools and worked with other health and social care professionals to ensure people’s needs could be effectively met. The provider used a “This is Me” document, which staff completed with people and their relatives as part of the assessment, to help to get to know the person and their preferences.

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.

Staff used assessments to form the basis of people’s care plans. The registered manager and nurses had a good understanding of people’s complex needs and worked with other professionals in line with best practice. They had systems to monitor people’s clinical needs. Staff took on roles to help support best practice and championed certain topics such as, oral care, person- centred care and IPC.

People’s care plans contained individualised information about their care needs. However, some contained standard sentences which were not personalised or were inconsistent. Some would benefit from further details to help guide staff. For example, guidance about how best to support a person when they displayed distressed behaviours or where a person had hearing loss the plan didn’t provide sufficient detail.

People were positive about the food on offer and staff met people’s individual needs. Where a person didn’t want any of the menu choices, staff clearly understood their likes and dislikes, offering an alternative which they much preferred. Another person told us, “I’m vegan and they have made sure everything I have is vegan.” The registered manager had systems in place to monitor and respond to any nutritional concerns.

The provider 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.

Staff worked effectively and maintained positive relationships with external professionals. A visiting health care professional provided positive feedback about the approach the service took towards joint working. For example, their allocated GP provided training about personalised care planning within end-of-life care. Regular multi-disciplinary meetings were held to share important information and agree approaches.

Staff told is they worked as a team and found there was effective communication. The registered manager ensured information was shared and communicated through various means. Daily handover meetings and staff meetings were held.

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.

Staff ensured people were referred to health and social care professionals for ongoing assessment and support where needed. For example, people had been referred to the mental health team, specialist nurses and dieticians. The GP undertook weekly visits to the home and reviewed people’s health needs. Feedback indicated staff were good at responding to changes in people’s needs and made timely referrals where needed.

There were examples where staff had supported people to recover and regain some independence, in some cases people had become more independent within the care home setting. Others had been supported to move back into the community.

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.

Staff proactively monitored people’s outcomes, which supported timely involvement of health partners and led to improvements, for example, in people’s health conditions and abilities. A visiting professional told us staff knew people well and were good at spotting any changes or health symptoms, which were addressed.

Systems were in place for people’s care plans to be reviewed monthly. Staff usually held review meetings with people and their relatives every 6 months, however not everyone we spoke with felt they had been involved in a recent review. Other feedback indicated staff communicated well and shared regular updates with relatives about any changes, on a regular and ongoing basis.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff considered people’s views and wishes, and their consent was recorded in their care plans. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received training regarding the MCA and policies were in line with the principles of the MCA. Staff had undertaken Mental capacity assessments and best interest decisions where required.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), DoLS applications and authorisations were correctly in place for people where needed.