Harcourt Gardens 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 newly registered service. This key question has been rated 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 and wellbeing needs. Care plans included detailed information about people’s medical conditions, preferences and support requirements.

People told us their needs were understood. 1 person said, “Staff are good, they know what I need,” reflecting staff knowledge of individuals.

Assessments were updated when people’s needs changed, and information was used to inform care delivery. Systems were in place to complete initial and ongoing assessments.

The provider had identified areas for improvement in the consistency of documentation, particularly in relation to initial assessments and care plan completeness, and actions were in progress to address these.

These arrangements supported effective assessment of people’s needs, with ongoing work to improve consistency.

The provider planned and delivered people’s care and treatment in line with current guidance and best practice. Care plans reflected assessed needs and included guidance for staff on how to support people safely, including managing risks such as falls, nutrition and skin integrity.

Staff demonstrated an understanding of people’s conditions and how to support them. A visiting professional told us staff were proactive in implementing clinical recommendations and updated records promptly following guidance.

People received care that met their needs, including appropriate responses to changes in health. For example, staff acted promptly following a choking incident by making referrals and reviewing care.

The provider had identified areas for improvement in consistency of care documentation, including MCA-related records, and actions were underway to strengthen practice.

Care was delivered in line with best practice, with ongoing work to improve consistency in recording.

The provider worked effectively with healthcare professionals and across teams to support people. Professionals told us communication was good, and said, “Staff are very good, timely and take responsibility, when sharing information and making referrals”.

Staff worked collaboratively within the home. Daily handovers and communication systems ensured important information was shared, supporting continuity of care.

External professionals confirmed recommendations were implemented and staff responded appropriately to changes in people’s needs.

The provider supported people to manage their health and wellbeing. People had access to healthcare professionals, including GPs and specialists, and were supported to attend appointments and receive treatment.

Records showed monitoring of health needs, including weight, nutrition and clinical conditions. Staff responded appropriately to changes, including timely referrals to external professionals.

Professionals confirmed that referrals were appropriate and made in a timely way, supporting early intervention and prevention of deterioration.

Care plans included information to support people’s ongoing health needs, and staff demonstrated awareness of how to respond to emerging risks.

The provider routinely monitored people’s care and treatment to improve outcomes. Systems such as audits, care reviews and daily monitoring charts supported oversight of care delivery and individual outcomes. Audit activity demonstrated measurable improvements, for example in infection prevention and control compliance. Staff described structured review processes, and visiting professionals confirmed staff “report back if there is any deterioration,” supporting early intervention. These systems enabled the provider to track performance and respond to changes in people’s needs.

The provider did not always ensure that people’s rights around consent and decision-making were fully respected or applied in line with the Mental Capacity Act 2005 (MCA). Although care plans referenced mental capacity assessments and decision-making processes, records showed inconsistencies in how these were completed and applied in practice. For example, people with capacity had consent recorded as being given on their behalf, and best interest decision-making records did not consistently evidence who was involved or how decisions had been reached.

Records relating to Deprivation of Liberty Safeguards (DoLS) and associated restrictions were not always clearly aligned with MCA principles. Associated assessments and best interest decisions were sometimes incomplete or unclear, and conditions linked to DoLS authorisations were not consistently reflected in care planning. This meant there was not always sufficient assurance that decisions were made in people’s best interests using the least restrictive option.

While some people told us they were involved in their care, and staff demonstrated an understanding of the need to seek consent, this was not consistently supported by clear and legally compliant documentation. Governance systems had identified these issues; however, they had not been fully embedded into practice at the time of inspection. This placed people at risk of not having their rights consistently upheld.