Stone Gables 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 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 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.

Assessments were not always reviewed and updated regularly to ensure information about people was current, and that care, support and treatment met their needs and individual outcomes as expected. Risk assessments were at times not up to date for example, 1 person’s oral health assessment had not been updated since 2023.

Staff did not always maintain clear and comprehensive care records. For example, repositioning charts were inaccurate. Records showed that 1 person who was required to be repositioned every 4 hours had a 5-day gap in completed records.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’s nutritional and hydration needs were not always met in line with current standards and evidence-based guidance. For example, we reviewed hydration and nutrition charts and found gaps where people’s food intake had not been recorded when on monitoring charts for their weight. We also found hydration charts did not always inform staff of the target levels people needed for the day to ensure they were not at risk of de hydration.

The provider did not always follow legislation and current evidence-based good practice and standards. For example, nationally recognised tools were not always used to assess risks, such as Waterlow (for the risk of pressure ulcers) and MUST (malnutrition risks).

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. Staff did not always have access to the information they needed to understand people’s needs and appropriately assess, plan and deliver their care, treatment and support. The provider was in the process of moving to an electronic system and therefore some care plans lacked information required, and staff did not have access to the new electronic systems. Staff also told us they did not always have time to read care plans. One staff member said, “It’s not very often staff get to read people’s care plans.”

Staff did not always support people to live healthier lives and where possible, reduce their future needs for care and support. Where people experienced swallowing difficulties, they were referred and assessed by the Speech and Language Therapists (SALT). Advice was included in people’s care records and catering staff were informed. We observed meals were prepared according to SALT advice. However, 1 person’s nutritional risk assessment identified they had lost weight, but their weight monitoring charts had not been updated since 2023, to demonstrate how staff were monitoring them for any further deterioration.

People provided mixed feedback about the food at the home. Comments included, “The food is very good”, “The food is alright” and “The food is not up to my standard.”

The service worked with healthcare professionals to ensure reasonable adjustments were made to enable people to access healthcare. During our assessment we saw district nurses attending daily to support people with their health needs. The service made sure referrals to appropriate health services were made quickly when people’s needs change and acted swiftly on their recommendations.

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.

Staff did not always monitor and evaluate outcomes related to people’s health and quality of life, including those linked to their aspirations and skill development, with a view to improving these outcomes when possible. For example, 1 person had identified 5 things they would like to achieve however, there was no evidence of these being carried out or evidence to show how they planned to support the person to achieve their goals.

The service did not always seek and consider feedback from people and their families as appropriate when monitoring individual outcomes. For example, 1 person’s last care review was completed in 2023 with their relative and no other recent reviews had been completed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff had completed their mental capacity training and were knowledgeable about the act. Records relating to mental capacity assessments and best interest decisions had been completed however, some of them had not been reviewed in the last 12 months. The provider agreed to review these.