Callands 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 service under the new provider. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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.

People’s needs were assessed prior to moving to the home. Staff undertook face to face assessments where possible. The home manager described how they took an individualised approach, talking to people and their relatives to help with the transition. A relative said, “They carried out an assessment at home first, in which he and I were fully involved, separately and together.”

Staff used recognised tools such as those to assess risks relating to pressure ulcers or weight loss. They were also using a new approach to pain assessment with the use of a digital tool to assess and score pain in people. This was particularly helpful to assess pain and offer support for people who could not always communicate their needs. Managers were embedding the use of this into staff practice.

The provider was making improvements to always plan and deliver people’s care and treatment with them, including what was important and mattered to them. They had introduced a new digital care planning system and were supporting staff to use this effectively. We received some positive feedback about the outcomes some people had experienced.

However, further improvements were needed to ensure people were fully involved in planning and reviewing their care. While some people told us they had been involved, several people and relatives said they had not discussed or seen their care plans. One relative told us, “We haven't been involved with her care plan. They seemed to get all the information they needed from the social workers and other places she had been before she came to Callands."

We found some care plans contained inaccurate or conflicting information. Staff had not always updated records when people’s needs had changed. For example, one person’s financial arrangements were recorded incorrectly, and another person’s care plan contained inconsistent information about their mobility and wheelchair use.

Care plans included guidance on repositioning people to reduce the risk of pressure damage. However, records showed repositioning was not always completed or recorded as planned. This meant the provider could not always demonstrate people received care in line with their assessed needs. The provider was monitoring this and taking action to improve practice.

The provider used a specialist catering company to supply meals, including texture-modified diets. The provider had focused on ensuring systems were in place to monitor people’s nutritional needs and respond to any 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 closely with other health and social care professionals. The management team engaged in regular multi- disciplinary meetings with the GP and the Enhanced Care Home Support Team. Feedback from visiting professionals indicated there were good working relationships with the staff team. One professional said they had seen service improvements.

Overall, staff told us they worked well together and that information was shared through handover meetings and through other means. Some staff felt frequent changes in management had impacted on the staff team and communication. The management team held monthly clinical review meetings to support and review clinical practice.

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 assessed and recorded people’s health needs as part of their care plans. They supported people to attend appointments and where required, referred them to other professionals for assessment and review, such as mental health support. People had access to dental input and their oral care needs were considered. A relative said, “The dentist and chiropody have visited for my husband.”

The well-being coordinator offered and promoted physical activities for people, such as armchair exercises. A relative said, “I see people are encouraged to join in events and activities, including ways of getting people to move and exercise more.”

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 andconsistent, or that they met both clinical expectations and the expectations of people themselves.

The provider had a 'resident of the day' system in place, where staff reviewed all aspects of a person’s care plan. Whilst some people and relatives were aware of this process, others told us they had not been involved. Reviews had not always identified inconsistencies in people’s care records or ensured they were fully updated when people’s needs had changed. The management team were monitoring and supporting staff to improve this, which was part of their action plan.

Staff generally communicated well with relatives and kept them informed. One relative commented, “They keep me informed of everything, for example yesterday they phoned about a change of medication. I feel very involved.”

The provider was making improvements to always tell people about their rights around consent and respect their rights when delivering care and treatment.

Staff usually sought people’s consent to deliver care. However, we found gaps in records relating to the application of The Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making decisions on behalf of people who may lack the capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When a person lacks capacity, any decisions made on their behalf must be in their best interests and as least restrictive as possible.

Staff had completed some records for MCA assessments and best interest decisions were undertaken. However, the quality of these varied, and in some cases had not been completed where required, for example where a monitoring sensor was used. The provider was aware this was an area for improvement, which was included in their action plan. They had completed a piece of work to ensure any restrictions to people were assessed and Deprivation of Liberty Safeguarding (DoLS) applications had been made where required.