Conifers 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 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. Initial assessments were completed and looked at healthcare needs, social history and social care needs. A wound care assessment was completed on admission. Evaluation of care plans were carried out but many entries were recorded as, 'no changes to care plan made.' Even when changes had been made to people’s care, they were not always captured in the evaluation. There were no evidence of people and their representatives being involved in reviewing their needs and ensuring their views were recorded.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. We saw staff offering choices of food and beverages to people at lunch time and throughout the day. We identified that the dining experience could be improved. There was minimal interaction between staff and people during lunch. One person required assistance with their meal, and while staff offered this support, they stood over the person during the meal. One person said, “The food is alright.” Another person said, “It’s [food] sometimes better than others.” However, people appeared to enjoy their lunch. We spoke with catering team, and they explained how they incorporated people’s preferences in the menu and had access to people’s dietary needs. The catering staff knew about modified diets and told us how they fortified foods and made fresh milk shakes twice daily.

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 and leaders worked well in partnership with external professionals such as the community MacMillian team, district nurses, dieticians and the palliative care team. External professionals complimented staff and leaders for their joined-up approach. One professional said, “I have witnessed effective communication, particularly at the point of transition from a hospital or other home setting, to ensure that patients and their families experience safe, coordinated care when moving between services. All referrals are received and dealt with promptly.” Staff within the home liaised with each other and passed on relevant information regarding people’s care.

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’s care plan documentation identified healthcare professionals had been accessed when required. Staff and leaders had made appropriate referrals to healthcare professionals such as community nutrition and dietetic service, chiropody, and district nurses. One external professional said, “The Conifers work collaboratively with individuals, carers and MDT [multi-disciplinary teams] to ensure patients are informed, empowered and able to make decisions that support their physical, emotional and psychological wellbeing. When the patient loses capacity they work always in the best interests of the patient and advocate for their advanced wants and wishes, while also supporting family members and the ones closest to them.” We saw care plans had a record of professional visitors which gave a summary of their visit.

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 and leaders were keen to ensure people received care and support which improved their outcomes. The home worked closely with external professionals to ensure people received appropriate care. However, some outcomes were not always recorded or documentation completed to show how they were met.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff included people in decisions about their care and support. During our inspection we saw staff offering choices and checking people were happy with their selection, for example at mealtime. One staff member said, “I am very polite and respectful, I will always ask permission from the resident if I can help them with personal care etc, I will never presume I can as it’s their right to say no. I try to make them feel comfortable and include them in their own care too. Imake conversations with them throughout.”