West Ridings 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 requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (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.

We continued to find inconsistency in the quality and level of detail of initial assessments carried out and in how relatives were involved by the service to provide relevant information to ensure people’s care plans were centred around their needs and preferences. Their comments included, “I have sat down with the manager who asked me for personal information such as [person’s] triggers and [their] life story” and “I have not seen a care plan, and I don't think I've done anything to support the care plan with this home. I remember doing this just in the original assessment with the social worker. The home has never asked me about [person’s] background information” and “I have never seen [person’s] care plan, and I haven't given the home any information about my [person’s] life or preferences.”

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

The service used nationally recognised tools to assess people’s needs however we found the outcomes of these assessments were not always informing the delivery of care. For example, people who had been assessed as being at very high risk of developing pressure ulcers, were not always repositioned at the frequency recommended.

The provided continued to not always work in line with best practice guidance in relation to medicine management, care planning and risk management, as well as the assessment and management of care for people living with dementia.

Regular clinical meetings had recently been introduced, but records were not kept of the issues found and actions taken to allow monitoring and analysis of trends and patterns.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Although staff told us they felt they worked well as a team, and the new management team had recently introduced new regular meetings, we continued to find examples where teams did not work well together to meet the needs of people. For example, one person’s skin integrity had deteriorated and although district nurses were made aware of concerns, managers at the service were not, so care documentation and additional checks on care had not been completed.

Healthcare professionals told us about inconsistencies in working with the service, with examples give of times when staff had followed professional advice and others when records were not kept of actions agreed.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People told us they were not supported to go into the garden or access the community to be involved in activities they enjoyed due to staff not being available. Their comments included, “To a point [happy living in the home], one of the problems has been getting outside.” A person told us when they asked for support to go out shopping, they were told “On a regular basis 1 of the staff could go out to the supermarket [for me instead]. I find this is not actually the case, that must be 4 months. It’s a bit difficult they can’t get you out.” A relative told us their loved one enjoyed going out in the garden and this was not happening. The lack of staff’s support created limited opportunities for people to be supported with a healthier lifestyle.

At our last assessment we found widespread concerns about people’s losing weight and no appropriate actions had been taken. At this assessment, we found improvements had been made in this particular area.

People gave us mixed feedback about meals. Their comments included, “It’s probably not the best food, ham sandwiches” and “Not too bad actually [food;” and “It’s a good selection [food]” and “Very good actually, [food], and it’s cooked beautifully.” The provider told us there were in the process of implementing improvements in this area.

We observed people being supported to choose their food.

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 and

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

Care plans were not always up to date, detailed enough to reflect people’s current needs or being followed by staff. Daily records of care were often incomplete or not monitored by management effectively to track progress or identify where changes were needed. For example, a person living at the service required considerable support with their sensory and mental health needs; we found care plans in place linked to their environment, personal care and activities were not being followed by staff which meant this person was at risk of social isolation and deterioration in their mental health.

Review of care were taking place, but there was no evidence of people and relatives being involved in these.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

We found inconsistency in the application of the Mental Capacity Act. Some mental capacity assessments had been completed for relevant decisions about people's care, but others had not. The provider told us this was an area they had identified for improvement.

At our last assessment we found concerns with deprivation of liberty safeguards (DoLS) not being submitted in a timely way. We found improvements in this specific area.