Badby Park

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 remained 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 46 (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.

People’s needs were assessed prior to moving into the service, this helped decide if people’s needs could be met. People, their families and commissioners were involved in this process. Some relatives told us they did not continue to be involved with reviews past initial assessment although other relatives were regularly involved in care and support reviews.

Regular reviews of care plans and risk assessments were completed, however, this did not always include a review of people’s care notes to establish what care was actually being delivered and how effective it was. We found evidence in care notes that care was not always being delivered as planned or to meet people’s needs and preferences. For example, where peoples care plans included preferred activities these needs were not met for everyone, particularly for people who could not communicate their preferences clearly. Where people had objected to an activity this had been recorded but staff continued to repeat the same activity. We were not reassured that staff always used the information available to provide person centred care and the management had failed to address this through the assessment process.

A staff member told us that when a new person moves into the home they receive information during handover.

The provider did not deliver people’s care and treatment in line with current evidence-based good practice and standards.

Nationally recognised tools were used to calculate the level of risks to people such as malnutrition, falls and pressure sores. However, care was not always delivered to prevent risk. For example, people had their weight checked regularly but pressure relieving equipment was not adjusted accordingly to people’s individual weight. This increased the risk of pressure sore development.

People were not always supported well with eating and drinking. Risk assessments and care plans were in place for people with specialist dietary requirements or people needing a specialist feeding regime such as a PEG. Records evidenced that PEG sites were not always managed safely, this meant there was increased risk of complication that could affect feeding and medication regimes. A relative told us that their relatives’ dietary requirements were not being met by the home as the choice was poor, this had discouraged them from eating. However, we observed where people did not like the food offered an alternative was provided. We observed people to be waiting for support with meals for prolonged periods of time due to there not enough staff to support.

The provider did not always work well across teams and services to support people.

The staff felt they were working well with other professionals. A staff member said, “The service communicates and works well with external partners like GPs, hospitals and we have our own therapy team at this site. This helps provide continuous care. Sometimes there can be delays, but staff try to coordinate quickly”. However, a visiting professional told us that communication could be improved and time saved if all staff followed the agreed procedure for information sharing. There had been an incident of poor communication with the pharmacy that had caused concern regarding missing medication.

There was a system in place for supporting people with transition into emergency care including providing information to ambulance crews and sending information with people to hospital to support their care while they were away from the service.

The provider did not always support people to manage their health. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

A staff member told us that people who had an increase in weight and were on a specialist diet did not always have the option of a smaller portion, they said this was due to specialist meals being brought into the home ready-made and in large portions. There was evidence of this in people’s records and the portions people were served. This showed a lack of communication from the homes staff on the units, the kitchen and therapy staff to promote healthy portion sizes.

Staff were aware of the need to encourage people to drink and we saw people had access to fluid and staff recorded and monitored people’s fluid intake. A relative said, “They [staff] try to push for fluids as [relative] doesn’t drink enough, and they need to.”

People had regular access to a GP and were supported to attend medical appointments. There was an in house therapy team to support people with rehabilitation, their mental health and well-being. A person spoke positively of their rehabilitation they said, “Its working really well”, they went on to tell us what they could do now that they couldn’t before.

The provider did not always monitor people’s care and treatment effectively to continuously improve it. Improvement was required in reviewing peoples care notes to ensure planned care was delivered and to avoid poor outcomes such as increased risk of pressure sores or social isolation and a decline in well-being.

The registered professionals within the therapy team monitored people who were for active rehabilitation and there was evidence of positive outcomes. A relative told us that their relative had received good support to improve their condition and they explained the positive progress to us. A person and their relative explained the long and short term goals that were recorded in care plans and being worked on and described improvement.

A staff member told us, there was not always enough therapy staff available to support people with monitoring and rehabilitation as they were relied upon for other tasks such as providing activities and supporting with meal times for people, which would not be necessary if units were better staffed.

The provider did not always respect people’s rights when delivering care and treatment.

Individualised mental capacity assessments were in place and Deprivation of Liberty Safeguards (DoLS) had been applied for appropriately. However, some improvement was required for staff guidance in peoples care plans on what people could or could not decide for themselves. For example, peoples care plans were more of a blanket approach with people described as deemed to lack capacity to consent to admission, care and treatment and people deemed to lack capacity to consent to their personal information being shared. It was not clear if some individuals could make some decisions about there care themselves for example, choosing what they would like to wear or choosing where in the home they would like to spend their time.

We observed and people and relatives told us that staff sought consent to care at the point of delivery.