The Swallows

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. The last rating for this key question was 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.

We identified a breach of Regulation 11 (need for consent) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care and treatment was not always effective. People’s needs, risks and choices were not always assessed and care plans were not always developed and reflective of their needs.

Care plans and assessments were not always completed for individual areas of need and risk and sometimes contained conflicting and confusing information. For example, a person’s care plan documented that they had capacity to consent for staff to manage their medicines, however, their best interest’s assessment documented that the person lacked capacity to make this informed decision. Another person liked to walk around the home, but had no care plan or risk assessment in place to guide and support staff to manage and monitor this activity safely. Another person’s pressure sore risk assessment indicated that a care plan was required to monitor and manage pressure areas. However, no care plan was implemented to ensure safe care and treatment. Another person’s diabetic care plan lacked detail and guidance for staff on the safe management of their diabetes including actions to be taken in the event of blood glucose levels being too low or high and the use of any rescue remedies.

People's diverse needs and wishes were not always assessed and documented. Assessments were not always completed and did not always include, people's needs relating to any protected characteristics in line with the Equality Act.

This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People’s care and support needs were assessed when they moved into the service. Assessments covered areas of people’s needs such as, moving and handling, nutrition and hydration, personal care and medicines management

Relatives told us they were involved in assessing and planning for their loved one’s care and support needs. One person’s relative told us, “The staff send me regular updates and information about my loved one and we reviewed their care plan last week.” Another relative commented, “The staff have reassessed my loved one’s care plan and sent me a report on it.”

People's nutrition, hydration, preferences, and cultural needs were met. One person’s relative told us, “My loved one likes the food. A year ago, staff put the menu plan on the dining room wall which was a good idea.” Another relative commented, “My loved one chooses to eat in their room; they really enjoy the food and eat very well.”

We observed how people were supported at lunch time. Where people required support from staff to eat their meals safely, including people who preferred to eat in their rooms, we observed that support was provided appropriately and with dignity. The food appeared to be well received, and people told us they enjoyed the meals provided.

Kitchen staff were knowledgeable about people’s dietary and cultural needs and daily menus offered choice. We saw information about people’s dietary needs, their likes and dislikes and where people had meals that met their medical or cultural needs. We saw an information board detailing the names of people that required modified textured diets where they were at risk of choking. The chef told us they received feedback and updates from care staff about meals and people’s changing needs and risks. They were aware of people’s cultural and religious dietary needs; they told us 1 person did not eat pork and 2 people liked to have Indian curries and biriani.

The kitchen was clean and well maintained. We saw food was stored safely and hygienically and food that had been opened had been labelled with the date of opening. The kitchen had received a food hygiene rating of 5 from the Food Standards Agency in December 2024.

Staff communicated effectively with other professionals. These included regular GP and district nursing visits to the service. A dairy was kept in the staff office to document people’s appointments with professionals.

A visiting health care professional told us, “I visit the service on a regular basis and staff are always very friendly. They always welcome you with a smile and know all the residents really well. Staff always seek my advice if they have any concerns about anyone. Staff are kind and I have no concerns about the care they give to people.”

A relative told us when their loved one fell a staff member went with them to the hospital. When they came back the staff member sat with their loved one all night rather than just putting up bed rails. The said staff had been very quick in picking up when their loved one wasn’t well and to get the doctor involved and prescribe antibiotics.

People were supported with their health needs. A relative told us their loved one got to see a chiropodist when they needed to.

People’s health needs were assessed; however, care plans did not always document and guide staff on how best people should be supported. We saw staff made referrals when people required medical healthcare and treatment and when staff needed advice and information for changes in people’s conditions.

A visiting health care professional told us, “I visit the service weekly and when people require it. Communication is very good and staff always email or call if needed. Diabetes is managed well, and staff provide us with electronic readings which helps to control and stabilises people’s diabetes. There is always enough staff when I visit and the manager or senior staff always accompanies me when I visit. Staff are very knoweladgeable about people’s individual needs and they do a good job. I have no concerns about the care staff provide.”

Staff monitored people’s health and wellbeing. Monitoring tools and records were in place; however, these were not always completed or reflective of people’s needs. Visiting health care professionals told us they had no concerns about the care people received.

People were asked to consent to their care and treatment. However, staff did not always work within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed.

Mental capacity assessments were not always completed in line with the codes of practice or had not been completed or reviewed where required. This meant that when people lacked the mental capacity to make some decisions about their care, staff failed to consult with their representatives and those who were important to them to make sure decisions were made in their best interests.

This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.