Walsingham Support - 1 Ashley Close

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 54 (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 ensure that people’s care and treatment were effective because they did not consistently check and discuss people’s health, care, wellbeing, and communication needs with them.

Some people’s needs were not assessed prior to moving in. One person moved from another home run by the same provider. Their care plan and all supporting information moved with them, but no new assessment of need was completed and the information contained within the care plan was not always accurate.

Staff were not always recording when people’s needs changed, and staff inconsistently recorded challenging behaviours, making it difficult to identify trends. This made it difficult to advocate for specific support to help people.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.Information was not always accurately recorded about people’s nutritional and hydrational needs.

People had undergone assessment by the Speech and Language Therapy (SALT) team. However, the outcomes of these assessments were recorded inconsistently across various documents and were not always incorporated into each person’s care plan. This lack of integration made it difficult to ensure that recommendations from SALT assessments were being followed as part of people’s day-to-day care.

During the assessment visit,we observed that the amount of food available in the fridge was limited, as the home was awaiting a food delivery. The food provided to people at that time was predominantly highly processed and lacking in nutritional value. In a detailed discussion with the registered manager, it was acknowledged that there were financial constraints due to a set budget. Nevertheless, the registered manager recognised that there was room to improve the quality and variety of food choices available to people.

Although a menu was provided which offered two meal options for people to choose from, it was unclear how individuals were supported to make their selections. For instance, during the second site visit, roast pork was listed as the intended meal; however, this option was unavailable, and a staff member instead prepared pasta as an alternative. Observations of the food served to people revealed that the meals were not visually appealing and the components did not always complement each other. For example, one meal consisted of mashed potato served alongside tinned curry, which did not make for a balanced or appetising combination.

Following the site visit the registered manager started to review the menu choices and we saw there was a change to the weekly food purchased to ensure it was more nutritious.

The service did not always work well across teams and services to support people. Care plans did not always contain sufficient information about people’s needs. Staff had, at times,stated they had carried out reviews of care plans and had recorded no changes. However, letters received from health professionals demonstrated that people’s needs had changed. One health professional told us they had good communication with staff, and they worked well together.

The registered manager was working to review care plans to ensure they were up to date and accurate.

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 need for care and support.

People were supported to access services tomaintainand improve their health. People and relatives told us that people received healthcare support when they needed it. For example, a relative said, “They are excellent at getting the GP to visit.”

Family members told us that people were supported to visit the dentist. Care records included information on how to support people with their oral hygiene and when to refer to the dentist.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Whilst there were processes in place, this needed improvement to ensure people's care and treatment were monitored effectively. Records were in place to monitor areas such as changes in people’s behaviour and nutritional intake. However, staff were not consistently recording information, which meant it was unclear what action staff took when people became unwell.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. There was inconsistent recording in how staff were completing best interest meetings, and these were not always specific. Many of the best interest meetings records were out of date and needed updating.The service had obtained consent from families to people having some vaccinations. However, mental capacity assessments and best interest decisions were not completed. This is not in line with the principles of the Mental Capacity Act 2005.

The registered manager understood their responsibility in ensuring up to date information was available in relation to people’s decision-making. The registered manager told us, “This is atask,and we are committed to ensuring staff understand how to support people within the principles of the MCA.”