Baylham 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 inspection 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 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.

The initial assessments of people’s needs were detailed and captured a wide range of information about people’s health, risks, preferences and support requirements. However, this information was not always consistently transferred into people’s care plans. As a result, care plans did not always fully reflect the detail contained within the initial assessments, meaning important information could be missed by staff when delivering day‑to‑day care. This increased the risk that care was not always planned or delivered in line with people’s assessed needs, and that staff did not always have clear, accessible guidance to support people in a consistent way.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. The manager acknowledged that care planning documentation required improvement. Although care plans were in place for people, information was often generic and not always clearly personalised to reflect individuals’ specific needs. In several records we reviewed, important details were either limited or duplicated across different care plans, which reduced clarity and made it difficult to be assured that the information related directly to the person receiving care. This lack of consistent personalisation meant that care plans did not always provide staff with clear, detailed guidance to support people safely and effectively in line with what mattered to them.

The provider worked well across teams and services to support people.

There was evidence within care records of involvement from external healthcare services, including when specialist advice or intervention was required. Referrals were made appropriately, and outcomes from professional input were generally recorded, helping to ensure people’s health needs were identified and addressed in a timely manner.

Staff handovers were taking place to support the sharing of information about people’s needs, risks and daily well-being. These handovers helped maintain continuity between shifts and supported staff to respond to any changes in people’s care.

The provider supported people to manage their health and well-being. Staff supported people to live healthier lives and, where possible, to reduce their future needs for care and support.

Feedback from relatives highlighted positive experiences, particularly in relation to nutrition and mealtimes. One relative said, “Yes, I would recommend Baylham Care Home for its caring staff and excellent food. The kitchen staff are brilliant. They produce delicious food cooked in the service’s kitchens throughout the day and on special occasions. My [family member] had a beautiful birthday cake baked by them. They have a 3-week meal rota printed out with a choice every day.”

Staff also described how people were supported to make choices around food and nutrition. One staff member said, “[People] are always asked what they want from the daily menu for breakfast, lunch, dinner as well staff are aware about their nutritional needs and swallowing issues.”

Overall, the provider supported people to manage their health and well-being. People were supported to access medical professionals as and when required. A staff member said, “If [people] require an appointment or GP referral [staff] make sure that they are supported and supervised by staff at all [times].”

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.

Systems to monitor, review and improve people’s care and treatment were not fully effective. Although auditing and quality assurance processes were in place, these were not consistently identifying shortfalls or driving timely improvements in practice. As a result, gaps in care planning and delivery were not always recognised or addressed particularly prior to the managers arrival at the service.

Despite these concerns, there was regular involvement from GP services and community nursing teams, who visited the service to provide treatments and support staff to meet people’s ongoing health needs. This multi-disciplinary involvement helped to mitigate some risks and supported continuity of care.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application

procedures called the Deprivation of Liberty Safeguards (DoLS). The provider had a system to track and monitor when people required a Deprivation of Liberty Safeguard to be in place. The provider followed the principles of the MCA when people needed to make decisions. DoLS applications had been submitted to the local authority for authorisation, in line with legal requirements.

We observed examples of positive practice where some staff sought people’s consent and offered choice prior to providing support, demonstrating an awareness of individuals’ rights and involvement in their care. However, we also noted that parts of the service, including areas of the ground-floor secure outdoor space, were locked. There was no evidence available to show that decisions to restrict access had been discussed with people using the service, or that individual risk assessments or best‑interest decisions had been completed to justify these restrictions. Records did not demonstrate how people’s views had been considered or how restrictions were regularly reviewed, raising concerns that access may have been restricted without appropriate assessment or consultation. Following our inspection visits the provider told us people could access the garden space as nursing staff have a key to that area.