Clarence House 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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.
 

This service scored 50 (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. Examples were found of incorrect information in people’s plans of care. For example, 1 person who was nil by mouth had information in their care plan pertaining to the preparation of foods and drinks to be consumed orally.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. We found examples of people having their preferences met, for example 1 person who requested wine with a meal had this provided for them. However, we also heard examples of people’s experience where this was not always the case. Some relatives told us at times staff had not acted upon requests for support, which led to relatives having to complete actions such as contacting the GP, collecting items from a pharmacy and providing care. One person’s care records indicated that they did not like to drink tea, however tea was listed as a drink provided to the person on their food a fluid chart. We could not be assured that people’s preferences were consistently followed, or that records relating to these were accurate.

The provider did not always work well across teams and services to support people. Information from health teams was not always accurately recorded within people’s care plans and records showed that in some instances recommendations were not followed. Some care plans contained inaccurate information about people’s care needs despite care plans having been reviewed. Professionals did tell us that staff were welcoming and contacted them for information and advice. Relatives gave mixed feedback about being kept informed. A relative told us, “Yes, if there were any changes, [staff] would let me know” but by contrast, another relative said, “[Saff] don’t update us on anything.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Records indicated that advice from health professionals was not consistently followed or recorded. Undated food and drink were found in dining area fridges and cupboards, and we could not be assured these items were safe to consume or that they were suitable for all people who had access to them. The provider did take immediate actions to remove food items of unknown date and label new food and drink items.

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 and consistent, or that they met both clinical expectations and the expectations of people themselves. Records showed that professional advice was not always followed and that food and fluid charts were not always up to date.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Individual staff members demonstrated an understanding of the need to gain consent before completing care tasks and had undertaken training relating to the Mental Capacity Act. However, the provider had not always recognised the need to notify relevant bodies when people’s needs changed. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that 1 person had a significant restriction added to their care plan in the form of one-to-one supervision. A review of this person’s Deprivation of Liberty Safeguards (DoLS) authorisation was not requested for 2 months, and the request did not make the supervisory body aware of how long this change had been in place. This was not in line with the current legal code of practice.