Fulford Care & Nursing 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 assessed and reviewed people’s health, care, wellbeing, and communication needs to ensure care and treatment was effective. Pre-admission assessments were completed to confirm the service could meet people’s needs.

Assessment processes were person-centred and supported partnership working. A range of tools were used to monitor people’s health and wellbeing, and information gathered was used to determine the level of support required. Multidisciplinary assessments informed care planning.

People were involved in their assessments and, where appropriate, relatives contributed to care planning. One relative told us, “I did all in my power to make sure she could live here.” Some people told us they had visited the service and chosen their room before moving in. One person said, “My relative was interviewed and shown this room. I’ve never regretted coming here.”

The provider planned and delivered people’s care and treatment in partnership with them, focusing on what was important and what mattered to each person. People told us they had opportunities to discuss their health and support needs. Care was delivered in line with legislation and current evidence-based good practice and standards ensuring support was provided in a personalised and non-discriminatory way. People’s protected characteristics, cultural needs, and personal preferences were considered to ensure care was tailored appropriately. We reviewed care plans; these were regularly updated to reflect changes in people’s needs and any professional advice received. Daily records demonstrated how staff supported people in line with their assessed needs and planned care.

The provider worked well with other teams and services to support people’s health and wellbeing. Treatment plans showed staff sought advice and guidance appropriately. Referrals were made for specialist support. Clinical staff coordinated treatment plans and worked with community matrons and the local medical centre to ensure people received continuity of care. Updates were shared through handovers, meetings, and care records.

People said staff worked closely with other professionals and they received consistent care and treatment. A person told us, “They do that quite well.” Visiting healthcare professionals told us communication between teams had improved and there was improvement in identifying when urgent care was needed.

The provider supported people to manage their health and wellbeing. People told us they received support with managing pain, health conditions, and dietary needs. Records showed people had access to healthcare services, and information from appointments was recorded and used to inform care. Staff discussed outcomes with people and involved them in developing treatment plans.

People told us they had enough to eat and drink. Feedback about the quality of meals was mixed, although people said this had improved following the appointment of a new chef. A person told us, “Lunch was nice today, I enjoy the food. We had a meat pie and vegetable and cake for dessert, very nice.”

The provider did not always ensure people’s care and treatment was effectively monitored to achieve good outcomes. Monitoring records were not always accurate or complete and did not consistently demonstrate that care was delivered in line with people’s care plans.

We found gaps in records relating to repositioning, fortified diets, and the management of constipation. Our observations indicated people were not always repositioned in line with guidance. Although there was no evidence people had experienced harm, these issues placed people at risk of avoidable harm. Following our feedback, the registered manager took action to strengthen monitoring processes.

Multidisciplinary assessments were used effectively to monitor changes in people’s health, including risks related to malnutrition, skin integrity, and pain. The service used the National Early Warning Score (NEWS2) to identify and track deterioration in people’s health, enabling staff to respond promptly when people’s conditions changed.

The provider was not always working in line with the requirements of the Mental Capacity Act 2005 (MCA). Decision-specific capacity assessments were not always in place or up to date for people who lacked capacity or had fluctuating capacity. Records relating to decision-making were not always robust. This meant the provider could not always demonstrate that decisions were made in line with MCA principles. There was no evidence of harm or impact on people’s care and treatment; however, these issues indicated governance processes were not always effective in identifying and addressing shortfalls in MCA compliance.

The provider had appropriately applied to the local authority for Deprivation of Liberty Safeguards authorisations. There was evidence of some best interest decision-making, including multidisciplinary approval for covert administration of medicines.

Following our feedback, the provider took immediate action to review and update MCA assessments and arranged refresher training for staff.