Chorlton Place 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 good, and people’s feedback confirmed this.

This service scored 62 (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 sought to deliver effective care and treatment by assessing and regularly reviewing people’s’ needs in collaboration with them and their representatives. Before admission, prospective residents underwent an assessment by Trusted Assessors. This process was to ensure the home was equipped to meet each person's requirements and informed the development of personalised care plans.

Monthly reviews were undertaken of care records. These records indicated that most individuals and their relatives were satisfied with the care planning process, although not all could recall being actively consulted. The provider operated a “Resident of the day” system. This meant one person received a full review of their needs by a staff member and people and their representatives were spoken with to ensure the accuracy of the information. One staff member shared, “I have been involved in ‘resident of the day’ reviews and worked closely with a community psychiatric nurse (CPN) to discuss goals residents would like to achieve. They’ve made positive progress.” Another staff member told us they completed resident of the day but were not given any protected time to complete the review during the shift which impacted on the consistency and information recorded in the care plan.

Staff demonstrated a clear understanding of residents’ needs. One explained, “Handheld devices show the essential care required, but we can access more detailed information on laptops. We’re given time to review these when needed, and alerts flash up on the device if there’s anything new, we need to be aware of.”

Relatives provided varied feedback regarding involvement in care planning. One commented, “If there are any changes, they tend to tell me when they get the opportunity. They work to [Name’s] schedule.” Another stated, “I saw the care plan when [Name] first joined, but I haven’t seen it since. Then again, nothing has changed for [Name].” A third relative noted they had not been involved in the assessment of their family member’s needs, although arrangements were being made to address this following the assessment.

The provider did not consistently plan and deliver care in partnership with people, nor did it always take into account what was personally meaningful and important to them. In some instances, care planning lacked a person-centred approach.

The service did not fully comply with guidance issued by the National Institute for Health and Care Excellence (NICE) in relation to the safe management of medicines. Specifically, national protocols concerning the storage and administration of oxygen were not consistently followed, and some staff were unaware of the relevant guidelines, posing potential risks to safety and compliance.

People’s nutritional and hydration needs were met in accordance with recognised best practice. The catering and care teams worked together to ensure individuals received a balanced and nutritious diet. Procedures for monitoring and responding to weight loss were appropriately implemented and evidenced.

Feedback regarding the quality of food was mixed; but some comments indicated that improvements were being made over time.

The provider aimed to support people in collaboration with other health and social care professionals. Where people required ongoing health surveillance, this was recorded in care records. We observed regular visits from multiple professionals during the assessment and outcomes from each review was recorded within the providers digital care record.

Staff reported that they received adequate information to support individuals upon admission to the home. In cases requiring further clinical oversight such as people presenting with compromised skin integrity prior to arrival, the staff team worked in close partnership with community healthcare professionals to develop and implement care aimed at improving health outcomes.

Feedback from external professionals was positive, with one professional stating that communication with the staff team was consistently effective. People were also confident in the care provided. One individual commented, “I can see the doctor regularly. The staff check to see if I have any sores, and I’m not going to break out [experience skin breakdown].”

The provider generally supported people to manage their health and wellbeing to maximise their independence choice and control. Staff supported people to lead healthier lives wherever possible, however, we found one person’s welfare was put at risk when staff failed to respond to a significant deterioration in their health.

Staff promoted independence by encouraging people to carry out tasks for themselves wherever possible. Staff received training to recognise early signs of infection or health deterioration, enabling timely intervention and appropriate care responses by using a National Early Warning Score Tool (NEWS), however, on one occasion we found the tool should have been used at a much earlier interval to assist in preventing a person becoming acutely unwell. The provider told us that further training will be provided to staff on using the tool effectively.

Access to healthcare was generally well facilitated, with residents able to see a general practitioner (GP) as needed. The GP practice conducted weekly health reviews to monitor and respond to changes to people’s wellbeing. A designated wellbeing coordinator promoted physical activity through structured chair-based exercise sessions, to assist in promoting people’s physical health.

Oral health assessments were completed for every person living at the home, and any concerns identified by staff were escalated to senior team members for further evaluation. Referrals to dental services were made when required.

Improvements were required to ensure care records remained current and responsive to people’s changing needs. Documentation did not consistently demonstrate that people were actively involved in decisions regarding their care and support, although this had been recognised by the provider as an area for development.

Digital systems were in place to monitor trends and support quality assurance processes; however, some electronic records lacked the necessary detail to ensure these systems were fully effective. For instance, a review of choking risks indicated that the provider could not confirm whether all residents had an eating and drinking care plan that reflected professional guidance. However, the review did not reference the care records reviewed so no further follow up action could be undertaken.

The provider informed people of their rights regarding consent and demonstrated respect for these rights in the delivery of person-centred care and treatment. Staff showed a clear understanding of the importance of obtaining consent prior to providing any care, support or treatment, and this was embedded within the provider’s assessment and planning processes.

Where people lacked the capacity to provide informed consent, appropriate processes were followed to ensure care was delivered in line with their best interests. Advocacy services were arranged for some people, and there was evidence of active involvement those advocates in reviewing care records and supporting decision-making. Care documentation appropriately reflected where individuals required assistance in making specific decisions.

The provider had identified areas for improvement, particularly in relation to mealtime choices. Efforts were being made to ensure people were supported to express their preferences, rather than staff making assumptions about their likes or dislikes.