Shoemaker Place

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

Systems in place monitor people's health conditions and improve their outcomes were not always effective. Although staff knew people well, people's needs were assessed, and care plans were in place however some care plans lacked information about the level of support required which meant people were not always referred to health agencies when needed. Although people told us they were able to choose the care they received, and staff respected their wishes, they were not always involved in care planning. The provider ensured appropriate decision specific mental capacity assessments were carried out however some improvements were required in recording sufficient information about how somebody had been assessed to lack mental capacity. Professionals supporting people living at Shoemaker Place did not always feel the care home always worked well with external health agencies.

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.

People gave mixed feedback about how much they are involved in their care planning. One person told us, “I have not seen my care plan or been to a review.” Another person told us, “My [relative] has Lasting Power of Attorney for health and welfare and is involved in reviewing my care plan.”

Staff knew people well. One staff member told us, “One of our residents requires lots of support with eating and drinking and with their mobility. We have worked closely with health agencies to make sure they have the correct mobility equipment in place to meet their needs.” While staff knew people well, care plans did not always include enough information to guide staff how to care for people and medical concerns were not always followed up in a timely way.

People's needs were assessed, and care plans were in place however some care plans lacked information about the level of support required. For example, where people had needs in relation to constipation and behaviours, these were not assessed or reviewed effectively. This meant people were at risk of not having their needs met. Care plans were mostly person centred and included their preferences in relation to communication and end-of-life care.

People told us they were not always involved in planning and reviewing their care.

While staff knew people well, care plans did not always include enough information to guide staff how to care for people.

People's clinical needs were assessed, and care plans were in place however some care plans lacked information about the level of support required. Where people required their fluid intake to be monitored due to a health condition, there was no guidance about how much staff should encourage them to drink and when they should take action if they had not had sufficient fluids.

People did not always feel staff, teams and services worked well together. One person told us, “I told staff I was feeling unwell but I’m still waiting to see a doctor.” Another person told us, “We do not see health professionals on the unit which is concerning.”

Staff gave mixed feedback about how staff, teams and services work together. One staff member told us, “We work well with health agencies. We assist district nurses and follow their recommendations.” Another staff member told us, “We work well with the GP who visits the care home regularly.” Another staff member told us, “Communication between the staff at the care home could be better as it’s a bit chaotic at times.” Another staff member told us, “The previous management were not proactive in chasing up referrals for someone who required specialist support.”

Professionals supporting people living at Shoemaker Place did not always feel the care home always worked well with external health agencies. One professional told us, “Although things are gradually improving, handovers have not always been good and there have been delays in referring people’s health issues to us.” Another professional told us, “We have had concerns about how the care home have been managing peoples end of life needs, skin needs and how they escalate concerns.”

The provider did not always work well as a team or with external agencies. While staff knew how to refer people to external health agencies when required, care plans did not always contain enough information about people’s health needs and when staff should refer to external agencies. This meant people were at risk of not having their health needs met.

While the people we spoke to expressed that they received good care, our assessment found people were not always referred to health agencies when needed.

While the staff we spoke to expressed people were supported to live healthier lives, our assessment found people were not always referred to health agencies when needed.

Systems in place to support people to live healthier lives were not always effective.

People we spoke to expressed that they received good care.

While the staff we spoke to expressed people were monitored where required and had good outcomes, our assessment found people were not always referred to health agencies when needed. This meant people were at risk of not having their health needs met.

Systems in place monitor people's health conditions and improve their outcomes were not always effective.

People told us they were able to choose the care they received, and staff respected their wishes. One person told us, “Staff knock on the door and ask what help I need before entering.” Another person told us, “Staff ask what help I need and encourage me to do what I can.”

Staff empowered people to make their own decisions about how their day to day care and support was provided. They understood people’s capacity to make decisions through verbal or non-verbal means. One staff member told us, “For people who can’t make decisions, I am able to know by someone’s body language if they are in discomfort and act in their best interests.” We observed a discussion between a staff member and a person requesting support with personal care. The staff member explained what they were able to do in their role and asked whether they would like support from a specialist health team to give them assurance.

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 MCA 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 Safeguarding (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. The provider ensured appropriate decision specific mental capacity assessments were carried out however some improvements were required in recording sufficient information about how somebody had been assessed to lack mental capacity. The provider ensured where best interest decision making was required, the relevant people were involved and least restrictive practices were considered. Applications were being submitted appropriately when DoLS authorisations were needed.