Stratford Bentley Care Centre

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.

People needs and preferences for how their care was delivered were assessed prior to them moving to Stratford Bentley Care Centre. This gave assurance the provider could deliver effective care and treatment for people’s clinical needs and meet their expectations. A care plan was created from the initial assessment and further developed from talking to people, their relatives and incorporating advice from external healthcare professionals.

Care plans and supporting risk assessments were reviewed each month to ensure they remained relevant, effective and reflective of people’s needs.

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.

The provider used recognised tools to assess and identify risks to providing people’s care and support. This included the International Dysphagia Diet Standardisation Initiative (IDDSI). IDDSI is a standard for describing food textures and drink thicknesses for people with swallowing difficulties. Using the IDDSI, care plans clearly identified how some people needed their food prepared or to what consistency they needed their drinks thickened to reduce their risks of choking. Supplementary food and fluids charts and daily records completed by staff, accurately recorded people’s fluid intake and how this was provided to people at the right consistency.

Kitchen staff told us they were informed about people’s nutritional needs and updated if those needs changed. This included in relation to any modified diets, allergies or weight loss. An external healthcare professional told us, “As a result of discussions they (staff) have all the IDDSI guidelines on display and documentation in the kitchen about their resident's recommendations. They are one of the rare homes where the chefs always ask for updates and the location of the kitchen makes this very easy.” The chef was confident people received their meals in a way that was safe for them.

People and their relatives were positive about the food in the home and how their nutritional and hydration needs were met. Comments included: “The food is very good; we have a menu and choices are offered and we have plenty to drink”, “The food is quite good; they encourage me to eat, and they offer me choices”, “We are offered plenty to drink all day” and “The food is excellent, and I am quite choosey. If something is on the menu that I don’t want, they would do me something else.”

Staff training was regularly refreshed to ensure they remained up to date with current best practice guidance. Staff had also received additional training from external healthcare professionals so people’s individual clinical needs could be met safely and effectively. This included dysphasia training from the speech and language therapy team and malnutrition prevention from dietitians. One healthcare professional who had delivered training told us, “The staff always are very interactive and engaged in the training sessions.”

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 had access to people’s risk assessments and care plans on the handheld devices they used to log the care they delivered. The registered manager told us this had improved information sharing as staff were able to clarify uncertainties by immediately accessing people’s care plans when they needed to.

Staff told us any changes in people’s needs was communicated to them through handovers at the beginning of their shift or via their electronic handheld device. One staff member showed us their device which had a highlighted banner across the screen informing staff of important information, as well as any recent updates.

The provider had processes to share information with external healthcare professionals who described communication as good. One external healthcare professional told us, “Communication between me and staff around recommendations is always done well and recommendations are followed. The staff are always very proactive in asking if there any changes in recommendations when I visit.” Another healthcare professional commented, “The staff working at Stratford Bentley Care Centre have a good grasp on the resident’s needs and their baseline in terms of their health and wellbeing. I feel that changes to resident’s physical/mental baseline are escalated in a timely manner to our team in order that we can establish causation and appropriate treatment strategies.”

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.

People were supported to maintain their health through regular appointments with other healthcare professionals such as the optician, chiropodist and audiologist. People were regularly weighed and when weight loss was identified, they were referred to dieticians and provided with a diet fortified with extra calories. A regular exercise class promoted independence by improving people’s balance and strength.

The provider monitored people’s care and treatment, but accurate records were not consistently maintained.

Some people required additional monitoring and recording to make sure care delivery met their identified needs. We found some daily records did not always accurately reflect risk management strategies were being met. For example, there were some inconsistencies in the records maintained when people needed to be regularly repositioned to maintain their skin integrity. Food records did not always accurately describe what people had eaten. Detailed records help staff and other healthcare professionals assess the effectiveness of people’s planned care.

The registered manager had already identified this as an area for improvement. They had reminded staff of the importance of accurate record keeping to evidence good outcomes for people at a staff meeting the week before our inspection visit.

One healthcare professional told us staff were good at monitoring peoples’ planned medical treatment. They explained, “Often the treatment plans our team put in place for residents include monitoring and escalation if further deterioration occurs. Staff at Stratford Bentley are very capable and willing to monitor patients and alert the appropriate people should further medical input be required.”

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

Our observations showed staff asked people for their consent in what they wanted to do or where they wanted to go. Staff were kind in their interactions with people and gave them time and space to make their own decisions. Where people lacked capacity to make complex decisions, staff still encouraged them to express their everyday wishes and preferences wherever possible. For example, in relation to what they would like to wear and how they wanted to be supported with personal care.

People's right to decline support was respected, but staff understood the importance of ensuring this did not impact on people's health and wellbeing. Staff told us they would give people time and encouragement to accept the support being offered. One staff member told us, “We try and encourage them, but they have the right to choose.” Another staff member explained, “I usually go back again and encourage them, but I make sure the nurse knows they have refused my support and I document it on the system."

Where people’s capacity to make a specific decision was questioned, formal capacity assessments had been completed. However, there was limited detail about how information had been shared with people to ensure they had been given every opportunity to participate in the decision-making process. The registered manager assured us this would be addressed with staff.