Harborne Lane 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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

People did not always receive support in accordance with the requirements of the Deprivation of Liberty Safeguards (DoLS) associated code of practice. This was a breach of regulation 13 safeguarding service users from abuse and improper treatment.

People did not always receive support in accordance with the requirements of the Mental Capacity Act 2005. This was a breach of breach of Regulation 11 need for consent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed prior to moving into Harborne Lane Nursing Home. However, improvements were needed to ensure people’s care plans were accurate and detailed the person’s involvement, the views of relatives, where appropriate, and other relevant health care professionals.

Assessments of need considered aspects of people’s care and support such as people's healthcare background, mobility, personal care and safety requirements. Care reviews were regularly completed, however this did not always ensure care records were up to date.

People’s individual needs were regularly assessed. A relative told us, “The GP comes regularly so I believe that any health issues will be acted on quickly, which is reassuring”

Staff knew people well and helped to ensure people received care and support that met their needs, health and wellbeing.

Although an initial assessment was completed prior to providing care and support to people, improvements were required to ensure all initial assessments detailed involvement of the person, relatives and other health care professionals.

We could not be assured the service always planned and delivered people's care effectively. The provider had not identified that some people's care plans were not always consistent or up to date. One person’s care records stated that they were seen by a specialist and their treatment had been stopped temporarily until next review. However, their care plan stated they were still receiving treatment. It was not clear from care records how the person should be receiving care and treatment. Another person’s care records related to pain management was contradictory. Care plans stated the person could not describe pain verbally or use nonverbal scale. However, staff we spoke with told us the person was able to express pain.

The service ensured people remained in contact with people who were important to them and facilitated visits.

The provider worked in partnership with various health and social care professionals and agencies, both internally and externally, who regularly liaised with the care home. This included external community-based GPs, local authority social workers and speech and language therapists. One external professional told us, “They are much better now at sharing information.” Another external professional told us, “Previously it was sometimes difficult to get information from the home, there have now been improvements and we receive key information”.

People were supported to access external health care professionals. This included supporting them when they expressed that they were in pain or discomfort or showing signs of an infection. People had health actions plans and hospital passports in place which were used by health and social care professionals to support them in the way they needed.

People were supported to attend annual health checks, screening and primary care services. Staff ensured people routinely attended scheduled health care appointments and had regular check-ups with a range of community health and social care professionals including GP’s and district nurses. In addition, people received support to eat and drink enough to maintain a balanced diet.

The service did not always effectively monitor people’s health conditions or ensure that records related to their care remained relevant and up to date to ensure improvements. This increased the risk of people experiencing poorer outcomes and receiving care that could not effectively meet their needs.

Improvements were needed to mental capacity assessment records and best interest decisions. Records related to Deprivation of Liberty Safeguards (DOLs) were not clear. Some records completed by staff did not evidence who was consulted as part of the decision-making process, such as relevant professionals or advocates.

Some DoLS applications were submitted but had not been authorised. There was no evidence the provider had contacted the local authority for an update on the applications, or to confirm if the person’s health and cognition had changed since the initial referral was made.

Some DoLS were allowed to expire before new referrals were made to the authorising body. This meant those people were at risk of being deprived of their liberty without lawful authority. We identified a handwritten note on another person’s DoLS records stating the person had regained capacity by their GP. There was no evidence to confirm the GP had made this decision or evidence of a Mental Capacity Assessment.

People told us, they were directly involved in making decisions about their care and support wherever possible. A relative told us, “I’ve been involved in the decisions about care”

Staff told us how they supported people to make their own decisions and in people’s best interests. Staff received Mental Capacity Act training and told us how they used the training to ensure people were given choice and control over their care needs. Care records in relation to consent indicated some staff members did not fully understand the importance of recording decisions and outcomes that demonstrated people had been given a voice.

One person had stairgates fitted to stop people entering their bedroom. There was no best interest documentation for the stairgates to be fitted and no evidence of any consultation. We raised these issues with the acting manager who took action after our site visit.