Haresbrook Park 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 remained good.

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

This service scored 67 (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.

Staff told us information relating to people’s care needs was available on the service’s electronic system. However, our review identified some care plans contained information that was out of date, lacked essential and accurate information, and sometimes care plans were contradictory. This demonstrated a failure to maintain accurate, person-centred records.

Some relatives told us they had not been involved in the assessment and review process. A person’s relative told us, “I looked at the care plan in the hospital the other week when he went after a stroke. It was out of date on his medication and mobility issues. The ReSPECT form was woefully out of date.” Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form is a personalized medical plan that outlines care preferences in case of a medical emergency. This meant we could not be assured records were reflective of people’s current needs, preferences, or wishes, or that they provided staff with the necessary guidance to deliver safe, effective care.

We raised this with the registered manager who took immediate steps to update care plans and risk assessments. They undertook a comprehensive audit of all care plans to identify and rectify any inconsistencies or inaccuracies.

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

When people were prescribed a specialist diet, records did not always confirm people received food with the appropriate consistency. We saw that 1 person’s care plan has not been updated appropriately following athickener prescription and recommended level of foods. This meant the person’s risk of chocking could have increased.

These issues were raised with the registered manager during the inspection, who took immediate action and provided assurances improvements would be implemented.

People had access to food and drink, and drinks were accessible to people. Staff had good knowledge of dehydration and malnutrition signs and symptoms. Fluid monitoring was discussed in handovers, and records showed intake and output were tracked.

People had access to a range of external healthcare professionals when required, including GPs, speech and language therapists, district nurses and other specialists.

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.

Health care professionals we spoke with were positive about communication and collaboration, noting positive joint working, responsiveness and information sharing. A healthcare professional told us, “The team at Haresbrook are welcoming, professional and always happy to engage in any discussions about changing ways of working, whether that be regarding proxy access, vaccinations or something else.”

People told us they were supported to attend healthcare appointments and access external services when needed. The Advanced Nurse Practitioner (ANP) visited the service regularly and could be contacted as required, which supported continuity of care and regular review of people’s needs and medicines. This meant people received coordinated care and support from a range of professionals.

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 supported people to manage their own health where possible and helped them attend appointments and complete tasks to stay well. One person told us, “They would help me if I was unwell, they helped me with (specific health condition) appointment.”

There were processes in place to guide staff on how to support people to lead healthier lives. Staff encouraged people to eat balanced meals and maintain good hydration to support their physical health. We observed drinks and food were available to people.

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.

Systems were in place to monitor care delivery, including the use of daily records, nutritional tools and risk assessments. Records demonstrated changes in people’s needs were identified and appropriate healthcare professionals were involved. Positive outcomes were evidenced in some areas, including improvements in weight and the maintenance of skin integrity.

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

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. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The provider had a system to track and monitor when people required a Deprivation of Liberty Safeguard to be in place. The provider followed the principles of the MCA when people needed to make decisions. DoLS applications had been submitted to the local authority for authorisation, in line with legal requirements.

Staff sought consent before providing care and supported people in a respectful and empowering way. A member of staff told us, “We are offering choices, looking at the response, and we make sure it's understandable for the person.” Where people lacked capacity to make decisions for themselves, best interest meetings were held which involved people’s representatives and other professionals involved in their care. These decisions were regularly reviewed to ensure they remained in people’s best interest.