Winscombe 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 changed to Requires Improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to consent to care and treatment and safe care and treatment. We identified care plans and risk assessments did not always reflect best practice.

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. Care plans were not always in place to support people effectively or contained contradictory information. For example, one person living with diabetes had no care plan or risk assessment to guide staff on how best to support them or the signs and symptoms to look out for if blood sugar levels changed and the actions to take. Relatives told us they were not always updated or involved when decisions were made about people’s care. There was no evidence within care plans to demonstrate that people had been consulted about their care and support or that their involvement was documented elsewhere.

We received positive feedback from an external healthcare professional in respect of the care people with Huntington’s Disease received. People were referred to a speech and language therapist (SaLT) when at risk of choking who provided assessments of swallowing for people. However, people had not always received their food in the recommended consistency and pureed food was not presented attractively to encourage people’s appetite The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

Although people and relatives told us staff worked well with other services, such as their GP, other care providers and community health services, we could not be assured this was always the case. Details in other areas of the report demonstrate health professionals guidance was not always followed such as when staff supported at people at risk of choking to eat and drink and the provider failed to notify relevant organisations about safeguarding matters. Where people required assistance with decision making, we identified the provider did not utilise support from advocacy agencies effectively.

People reported they were able to access health services, with support from staff where needed. This included support to plan hospital visits to ensure they went as smoothly as possible. Staff supported people to access local healthcare professionals where appropriate. The registered manager told us they had good links with GP surgeries and community professionals.

The provider did not always monitor people’s care and treatment to improve it. Staff and visiting professionals generally expressed people were monitored where required and had good outcomes, However, daily records did not always detail the care and support people received. Care plan reviews did not always document improvements and positive outcomes in relation to health concerns, mobility and mental wellbeing. People were not always referred to health professionals promptly for example, when they were not effective managing their own medicines or after potential choking incidents. This meant people were at risk of not having their needs met safely.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. Where a person lacked capacity to make decisions in relation to their care and support needs, we identified the principles of the Mental Capacity Act 2005 had not been adhered to, this included ensuring people were supported to make their own decision. Despite no records of consent being obtained, everyone in the service had bedrails in place. There was no evidence to demonstrate alternative methods of restriction had been considered. When restrictions were implemented, the service did not ensure they involved the right people in the process to ensure decisions were made in the person’s best interest. The arrangements in place for storing and managing people’s finances were also not agreed in accordance with the principles of the Mental Capacity Act 2005 and did not upheld people’s rights.