Lower Bowshaw View Nursing 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

The new manager was aware of improvements required. People’s needs were assessed and documented in plans of care. People’s care plans reflected their physical, mental, emotional, and social needs This included any protected characteristics under the Equality Act 2010. However, we found staff did not always document care and support delivered to ensure needs could be effectively reviewed, monitored, and evaluated. Where people were assessed as lacking capacity to make a particular decision, the provider followed best interest processes to protect people's rights. People had been referred to other health professionals as required such as the district nursing service. However, communication with professionals could be improved to maximise the effectiveness of peoples care and treatment.

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.

People and relatives told us they were involved in the assessment of their needs. The management team were aware of improvements required.

Staff assessed people's needs using a range of assessment tools to ensure their needs were reflected and understood. The care plans reflected people’s needs the new manager was aware the documentation at review and follow up required improvement.

People had a comprehensive assessment of their needs, which included consideration of their clinical need, mental health, physical health, wellbeing, nutrition, and hydration needs. However, we found staff did not always document care and support delivered to ensure needs could be effectively reviewed, monitored, and evaluated.

Nutrition and hydration needs were assessed and detailed in plans of care; however, these were not always met. For example, we found a number of people had lost weight, yet it was not clear if nutritional supplements or snacks were offered or given as these were not documented so was not clear the plans of care were followed. Clinical reviews were carried out and the GP visited regularly, however, feedback from professionals was that the experience for people could improve if staff communicated better and were better prepared for the reviews. People told us the food was nice, one person said, “The meals aren’t bad but there isn’t enough variety.”

Nutrition and hydration needs were assessed and detailed in plans of care, staff were aware of the people who needed a specialised diet and/or soft diet to ensure their needs were met. The staff told us referrals were made to ensure people’s health needs were met. However, there was not always clear documentation to be able to effectively review and monitor care needs.

Processes were in place but not always followed to ensure they were effective. Lack of documentation did not evidence that best practice was met.

When staff interacted with people, they were kind and caring. However, we observed staff could be task orientated in their approach. We did not see management directing, mentoring, or deploying staff to ensure care was person centred.

The management team has been changed to better support staff and improve the quality of service provided and ensure positive outcomes for people.

Professions feedback was staff did not effectively communicate with each other to ensure effective care delivery. The new manager has identified the shortfalls and is working with staff to improve staff support, supervision, and communication.

People’s choices were documented in plans of care, however, we observed at times people were not supported to make choices and decisions.

People were supported to manage their health and wellbeing. The service promoted people’s wellbeing by providing daytime activities. Communication could improve between staff and professionals to better manager people’s health and well-being. Relatives told us they were kept fully informed about their family member's wellbeing.

The new manager told us they were implementing better systems to improve service delivery.

In people’s records we found evidence of involvement from professionals such as doctors, optician, tissue viability nurses and speech and language practitioners. However, processes required improvement to better facilitate effective communication between professionals.

People’s care was monitored to ensure they received the care and treatment they needed. However, this was not always followed up effectively to ensure positive and consistent outcomes.

The new manager told us they would be working alongside staff to support them to ensure effective monitoring of people’s care and treatment and their outcomes.

The provider had systems in place to ensure people's outcomes were met. The provider was taking action to ensure people consistently experienced positive outcomes by implementing a new management team and upskilling staff.

People were made aware of their rights around consent, and these were predominantly respected. Where people lacked capacity appropriate legislation was followed.

The new manager understood the importance of ensuring that people fully understood what they were consenting to and the importance of obtaining consent before care was delivered.

We checked whether the service was working within the principles of the MCA. The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The service was aware of the need to and had submitted applications for people to assess and authorise that any restrictions in place were in the best interests of the person.