Wavertree Nursing and 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 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 made sure people’s care and treatment was effective by assessing andreviewing their health, care, wellbeing and communication needs with them.

The provider used nationally recognised assessment tools when assessing people prior to admission to ensure their needs could be met. The manager described speaking to people and their relatives directly to gain a better understanding of their needs. One person’s tailored communication need ensured social inclusion. Other people with complex care needs, such as PEG, tracheostomy or catheter care, had personalised and detailed care plans to guide staff in providing appropriate support.

Staff confirmed they knew the needs of people via handovers, care plans or from the nurse or senior. Relatives confirmed there were involved in the care planning. One relative told us, “I am consulted about their care all the time.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Clinical tools such as malnutrition universal screening tool (MUST) and waterlow were in place to assess people’s needs. The waterlow score helps identify people who are at high risk of developing pressure ulcers, enabling healthcare professionals to implement preventative strategies. However, we identified these strategies were not always adhered to.

Whilst the provider made appropriate referrals to SALT (speech and language therapy) at the earliest indication of any risk of choking care plans were not always updated to reflect this change in need and ensure individuals received specialist individual support

Meals were prepared for those people who required a specific diet. For example, desserts were home made for people with diabetes, special foods were ordered in for those requiring kosher food and food was prepared in line with people’s varying consistencies to help with swallowing difficulties. Regarding one person’s modified diet, their relative told us, “They have found how to make it appetising.”

People were assisted to eat and drink, however, some staff felt rushed at mealtimes.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.

Records were in place to demonstrate when staff had made referrals to other agencies. There was a handover system to share important information and update the staff. The manager had daily oversight of clinical needs to ensure any concerns were promptly escalated and appropriate referrals were made without delay.

All staff told us they promoted independence. One staff member said, “I do basic things like giving the resident a face cloth during washing if they are able to do this themselves.” Another staff member stated, “I would ask if they would like to do certain tasks and if not, ask if they want me to do it.”

People were supported to access other routine healthcare professionals, for example, opticians and podiatrists.

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 andconsistent, or that they met both clinical expectations and the expectations of people themselves.

Staff were not consistently following repositioning instructions. For example, one person who required repositioning every 2-4 hours had not been repositioned for over 5 hours 17 times in one month and one occasion this person remained in the same position for up to 13 hours. This increased the risk of new pressure sores developing and delayed recovery of existing wounds. One person’s skin integrity plan had not been updated despite a new wound being identified.

Monitoring people after an incident was not always robustly documented. For example, one person who had a fall was not monitored in line with the provider’s falls protocol. This demonstrated a lack of commitment and responsibility to people’s health and safety.

However, people had access to regular clinical input, including visits from GPs. The manager had recently ensured they were involved in daily meetings to ensure greater oversight. Daily monitoring of wound care was implemented.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.