Fordingbridge 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 of this key question, 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.

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.

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.

People’s communication methods were outlined within their care plans to enable them to receive care and treatment which worked for them. Care plans we looked at identified any difficulties with communication, such as hearing or speech. However, there were some inconsistencies noted in care plan content, which meant it was not always easy to fully understand people’s needs. For example, we looked at the plan for one person where it was documented they were unable to communicate their needs, but it was also

documented they were a content and happy person and did not feel isolated. It was unclear how staff had reached this conclusion. Other people’s communication plans provided clear information for staff.

Some care plans we looked at contained copied and pasted information. The same detail had been documented in several people’s care plans. This did not evidence that people’s needs had always been individually assessed.

We saw examples in some care plans where not all aspects of people’s care needs had been assessed or documented. This meant there was a risk staff would not know how to support people.

In other plans we saw conflicting information, such as it being documented a person had no teeth or dentures, but still needed staff support to clean their teeth.

People were assessed face to face prior to moving to the service. This meant the management team were able to confirm the service could meet people’s needs. One staff member said, “[Clinical manager] does the assessments for new residents. We get given the pre-assessment documents, and information from social services and work out where is best for people to be [in the building] based on their needs.”

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.

People’s communication methods were outlined within their care plans to enable them to receive care and treatment which worked for them. Care plans we looked at identified any difficulties with communication, such as hearing or speech. However, there were some inconsistencies noted in care plan content, which meant it was not always easy to fully understand people’s needs. For example, we looked at the plan for one person where it was documented they were unable to communicate their needs, but it was also

documented they were a content and happy person and did not feel isolated. It was unclear how staff had reached this conclusion. Other people’s communication plans provided clear information for staff.

Some care plans we looked at contained copied and pasted information. The same detail had been documented in several people’s care plans. This did not evidence that people’s needs had always been individually assessed.

We saw examples in some care plans where not all aspects of people’s care needs had been assessed or documented. This meant there was a risk staff would not know how to support people.

In other plans we saw conflicting information, such as it being documented a person had no teeth or dentures, but still needed staff support to clean their teeth.

People were assessed face to face prior to moving to the service. This meant the management team were able to confirm the service could meet people’s needs. One staff member said, “[Clinical manager] does the assessments for new residents. We get given the pre-assessment documents, and information from social services and work out where is best for people to be [in the building] based on their needs.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported people to access support from health care professionals such as the GP, specialist nurses, the optician and hospital appointments, when required.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported people to access support from health care professionals such as the GP, specialist nurses, the optician and hospital appointments, when required.

The provider did not always routinely monitor people’s care and treatment to continuously improve it.This was an area for improvement as the provider had not identified the shortfalls found under MCA assessments and assessing people’s needs. The provider has given a commitment to make these improvements.

While we found care plan assessments were not always clear, we saw some evidence that staff reviewed people’s care plans with people and their relatives. A staff member told us, “Care plans are reviewed monthly, or sooner if required. Families are invited to take part, although some choose not to.”

Minutes of monthly clinical governance meetings showed that outcomes were monitored. One health professional told us, “I have no concerns, it feels good here. They’ve put in a lot of effort with the residents, and they have a consistent staff team who know people well.”

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

People had not always been assessed for their mental capacity to consent to all aspects of their care. Additionally, not all mental capacity assessments we looked at were decision specific.

We viewed mental capacity assessments and best interest decisions for 5 people. Overall, there was some evidence of meaningful and well thought through mental capacity assessments and best interest decisions being carried out, particularly such as the ones carried out by the registered manager. However, there was also a pattern of generic information, possibly cut and paste information, decisions made before carrying out a best interest decision, and lack of evidence of the views of important others. This means that people’s rights may not fully be protected in relation to the Mental Capacity Act (MCA) 2005.

The provider’s continuous improvement plan stated a MCA workshop was planned for all nursing staff, to focus on enhancing nurses' understanding of the principles of the MCA, assessing capacity, and making best interest decisions. The aim of the workshop was to strengthen compliance, promote good practice, and ensure nurses were confident in applying the MCA in day-to-day care. Dates for the workshop were being finalised, and attendance would be mandatory for all nurses.