Lilleybrook 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 good. At this assessment the rating has remained good. This meant people’s outcomes were generally good, and people’s feedback confirmed this.
 

This service scored 67 (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 consistently ensure that people’s care and treatment were effective, as care planning did not always accurately reflect people’s current needs.

Systems to review and update care planning were not always effective. Recording of risk management processes required improvement. While actions were often taken in response to changes in people’s health, these were not always supported by clear or detailed risk assessments. For example, one person with diabetes had conflicting information in their care record about how frequently their blood glucose needed to be checked. Whilst we saw no evidence of impact to the person, there was inconsistent guidance to support staff to monitor, identify risks or outline escalation procedures. Similarly, information relating to how specific health conditions affected individuals and how these should be managed was not always clearly recorded.

Where changes to people’s needs were identified, this information was shared with staff through handovers and ‘eleven at eleven’ meetings, and staff confirmed they had read and understood updates. This supported day to day communication within the team and enabled staff to respond to people’s changing needs. Despite this, written care plans did not always reflect these changes, which meant records were not consistently aligned with current practice. This meant that we were not assured that all staff would have access to reliable and up to date guidance to deliver care consistently.

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

The Waterlow Pressure Area Risk Assessment was used to identify and manage people’s pressure ulcer risks, and the Malnutrition Universal Screening Tool (MUST) was used to monitor and manage risks associated with malnutrition or obesity. Staff were trained to use these tools, and the outcome of these assessments determined the care required. Whilst we saw that this had previously been identified and documented as completed on the service improvement plan, more time was needed to ensure care records were consistent and fully reflective of people’s current needs and any associated risks.

Where people required specific food and drink consistencies, these needs were not always consistently or clearly reflected within care planning documentation and daily notes. For example, one person’s care plan documented that they required thickened fluids, but also stated in their sleep care plan that they liked to have a jug of water by their bed. The provider told us this was an isolated recording inconsistency, and took immediate action to resolve.

The provider’s systems provided staff with assessments and care planning tools which aligned with national standards, evidence-based practice and guidance which were widely recognised by health and social care professionals. This meant visiting professionals also understood the information these provided.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us there was good communication within the staff team, and staff worked collaboratively to meet people’s needs. Eleven at eleven meetings and handover meetings were held at each shift change to ensure staff were kept up to date with people’s health, wellbeing and any changes to their care.

Staff worked with external professionals when required, including general practitioners, emergency services and safeguarding teams when concerns arose. We received mixed feedback from professionals about the effectiveness of partnership working. Some professionals told us the home did not always engage with them effectively to support people, whilst other praised the partnership working. One professional said, “I have always found the management staff at Lilleybrook helpful and approachable. [The registered manager] emails me with any concerns and is always very responsive to my emails if I have any questions of queries.”

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, people and relatives praised the improved activities within the home. One of the activities co-ordinators told us, “[People] and staff are so much happier now there is more going on and more [people] want to engage. They can see that everyone is genuinely having fun so they approach us.” A relative told us, “[My loved one] is supported to do activities and [I see] him participating on the home’s [social media] page. They are opening a bar at the home which [I think] he will like.” A person told us, “Since the new activities coordinator started it has been a lot of laughter and a lot of singing.”

The service demonstrated a commitment to reducing social isolation. Where people chose to spend time in their rooms, staff ensured they remained engaged in ways which reflected their preferences. One person told us, “I used to do activities [but my health needs have changed]. They now come to the room and do activities with me. [The other day] they piled in and danced in the room and sang with me. It was really wonderful. It was a laugh. [A member of the activities team] comes in most mornings to talk to me and see if I need anything. Then [they come] in to see me before [they] go home.”

Staff told us they had a good understanding of people’s health needs and said they had the guidance they needed to provide effective support. Despite this, we saw inconsistencies in records such as care plans and risk assessment, which required updating. The registered manager was reviewing people’s needs on a daily basis, but told us they would review all of the records to ensure they consistently reflected people’s health and wellbeing needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff maintained records of the care they had provided and observations of people, for example, details of anxiety and distressed reactions. Records demonstrated changes were shared with health and social care professionals where needed. However, improvements to care records were needed to avoid ambiguity and ensure there was a clear and consistent record of monitoring and observation. For example, where people required food to be given at a specific texture or consistency, the record did not always clearly evidence what people had consumed. Whilst we saw no evidence of impact, the absence of a clear record meant that we could not be assured people were supported to eat and drink in accordance with their eating and drinking guidelines.

Despite the concerns we identified in relation to the care records, we saw that information about people’s care needs was regularly shared through daily handovers so that staff were aware of changes and could adapt the care they provided accordingly.

The provider told people about their rights around consent and respected these when delivering care and treatment.

Where people lacked capacity to make specific decisions, staff followed the principles of the Mental Capacity Act 2005 (MCA). This ensured that care was delivered lawfully and in line with people’s wishes. Deprivation of Liberty Safeguards (DoLS) authorisations were in place where required, with involvement from family members or representatives.

These arrangements demonstrated decisions were made lawfully when people lacked capacity, and staff recognised when formal processes were required to support people’s rights. Despite this, some aspects of the record keeping related to consent and capacity practice needed to be further developed. For example, while capacity assessments and best interests’ decisions were in place, these were not always consistently reflected in care planning documentation. Whilst we saw that this had previously been identified and documented as completed on the service improvement plan, more time was needed for this to be fully embedded to achieve greater clarity and consistency in care records.

Staff received training in the Mental Capacity Act (MCA) and DoLS to ensure they understood the importance of gaining consent before providing support. A relative told us, “[My relative] gets to make choices; [they] can get up and go to bed when [they] want to and [they] call Lilleybrook [their] home.