Four Oaks 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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.
 

This service scored 75 (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’s needs were assessed through established admission, assessment and review processes. Comprehensive admission assessments, risk assessments and care plans were in place, which reflected people’s physical health, nutritional needs, mobility, communication requirements and identified risks. New admissions were supported by medicines reconciliation, nutritional screening and other assessment processes to help ensure people received care which reflected their individual needs from the outset.

Assessments were reviewed when people’s needs changed, including following hospital admissions, deterioration in health or professional intervention. Records demonstrated care plans and risk assessments were updated to reflect changing needs and professional recommendations.
 

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.

People received care and support informed by recognised assessment tools, professional guidance and specialist healthcare input. Care plans reflected current needs and professional recommendations. Records demonstrated advice relating to nutrition, skin integrity, medicines management and risk reduction was incorporated into people’s care and reviewed when circumstances changed.

The provider had effective monitoring arrangements, including enhanced nutritional oversight, medicines reconciliation reviews, competency assessments and governance scrutiny. Staff demonstrated an understanding of key processes relating to medicines administration, nutritional monitoring and escalation of deteriorating health.

The provider worked with healthcare professionals to ensure treatment and support reflected current guidance and individual needs. Whilst some areas of practice continued to be monitored through ongoing improvement plans, care and treatment were delivered in line with recognised good practice and supported positive outcomes for people.
 

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 worked collaboratively with healthcare professionals and other agencies to ensure people received coordinated care that reflected their changing needs. Professional recommendations were incorporated into care plans and staff demonstrated an understanding of when concerns should be escalated and referrals made.

Information about people’s needs, preferences and risks was shared effectively across staff teams through, handovers and regular communication. Staff demonstrated a consistent understanding of the people they supported and were able to describe changes in care and support arrangements.

Staff described clear routes for obtaining professional advice and escalating concerns when required. Information from multidisciplinary involvement was reflected in care planning and ongoing reviews, supporting continuity of care and helping to ensure people received coordinated support from the services involved in their 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 were supported to access healthcare professionals when required, and staff recognised changes in health and wellbeing that needed further assessment or intervention. Involvement from GPs, dietitians, district nurses and other professionals to helped people maintain their health and respond to changing needs. Nutritional risks, skin integrity concerns and deteriorating health were identified and reviewed through established monitoring processes.

People at increased risk of deterioration received enhanced support and monitoring, including nutritional assessments, weight monitoring and referral to healthcare services where required. Staff demonstrated an understanding of how to recognise changes in people's health and explained how concerns would be escalated to ensure people received appropriate support in a timely way.
 

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.

The provider monitored a range of health, safety and wellbeing outcomes to help ensure people received safe and effective care. Systems were in place to review areas including nutrition, medicines, falls, skin integrity and other factors that could affect people's health and quality of life. Monitoring arrangements helped staff identify concerns, respond promptly and reduce the risk of deterioration.

There was evidence of regular review of nutritional risks, medicines management and wound care. Significant weight changes, Malnutrition Universal Screening Tool [MUST] scores and skin integrity concerns were discussed through established monitoring and review processes, and action was taken when risks were identified. Staff were able to explain the arrangements used to monitor people at increased risk and how concerns were escalated to healthcare professionals when required.

Information gathered through monitoring activities was used to inform care planning, review risks and support improvements in care delivery. These processes helped the provider identify emerging concerns, implement appropriate interventions and support positive outcomes for people living at the service.
 

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

The provider had systems in place to support consent, decision-making and compliance with the Mental Capacity Act (MCA). Records reviewed demonstrated the use of mental capacity assessments, Best Interest decision-making processes and Deprivation of Liberty Safeguards (DoLS) arrangements where restrictions were required. Family members and representatives were involved in care planning, reviews and decision-making where appropriate, and staff were able to describe how people who lacked capacity were supported to make decisions in their best interests.

Restrictive interventions and significant care decisions were linked to MCA, Best Interest and DoLS processes. The provider maintained oversight of DoLS authorisations through monitoring systems and review arrangements, and there was evidence any restrictions were recognised and subject to governance review. Records reviewed demonstrated people’s rights, choices and legal safeguards were considered when planning and delivering care.