- Care home
The Park Residential and Nursing Home
Report from 2 April 2024 assessment
Contents
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
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. People’s needs and clinical risks were assessed, and care and support delivered in line with current standards to achieve good outcomes for people. Recognised ‘evidence based’ assessment processes such as those designed to identify risks relating to skin integrity and malnutrion were used to inform people’s care and treatment. People’s care was monitored and progress made towards improved outcomes for people with people supported to live healthier lives. Processes were followed to ensure people consented to their care and treatment.
This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Assessing needs
People felt staff knew them. One relative told us their family member had been unwell recently and staff had recognised this and helped to get a review with the GP. Another person told us they understood they were in the process of being assessed with a view to returning home. People told us staff checked with them and their relatives about their care and whether any changes were needed. A relative told us their family member’s care plan had been discussed with them when they moved in. This helped involve people in their care needs.
Leaders told us there was a ‘staff champions’ system in place for people’s key clinical risks. They told us this helped to improve oversight of these risks. Staff were able to demonstrate how nationally recognised tools were used to inform people’s care. Staff felt care plans provided sufficient information to help them support people safely.
People’s needs were appropriately assessed using evidence-based tools. This included tools designed to identify and reduce risks for areas such as malnutrition and pressure sores.
Delivering evidence-based care and treatment
People told us they were happy with the food choices they had. One person told us they had asked for some changes to how the vegetables were cooked and they preferred to purchase some of their own food, and this had been supported. A relative told us staff had bought soup up to their family member when they had been unwell to help them maintain their nutritional intake.
People’s food and fluid intake was monitored to help identify any concerns. Leaders explained they regularly reviewed these records charts to ensure people were eating and drinking enough. Staff explained that some people using the service had their food and fluid intake monitored and understood the rationale behind this. This helped them monitor changes in people’s needs and make referrals as necessary.
People’s care records showed they received support that was evidence based and in line with good practice standards. For example, where a tissue viability assessment had identified a person needed regular repositioning to maintain their skin integrity, daily records showed this was carried out. People’s nutrition and hydration needs were met as daily records showed people were supported to eat and drink enough to meet targets to maintain their health and wellbeing. Diet notifications were in place to support staff in understanding people’s dietary requirements. This included diet modifications in line with guidance from the ‘speech and language therapists’ or fortified diets.
How staff, teams and services work together
People felt staff worked well together to help people experience good care. For example, one person told us staff knew who they liked to spend time with and they helped them both sit together. Another person told us they liked how staff regularly checked with people about their care and checked they were happy.
Staff spoke positively about the electronic system the provider used for care planning and information sharing. There was a specific handover feature which meant key updates were easily communicated between the staff, this included any feedback from healthcare professionals regarding people’s care needs.
Partners all felt staff were willing to work with them and this worked well. When partners had left guidance for staff to follow this had been implemented. Partners reported leaders in the service would contact them to discuss any issues.
The provider’s system for care planning allowed for a hospital transition document to be easily generated in the event a person was admitted to hospital. This would pull off all important information about the person’s health and associated risks. It also allowed for information to be highlighted for discussion in the staff handover meeting (when staff changed shifts), so staff could easily communicate any changes in people’s needs to the new staff team.
Supporting people to live healthier lives
People told us they were supported to live healthier lives. One person told us they had seen the GP that morning and discussed their medicines and that a referral was being made for them to access physiotherapy. Another person told us their relative took them to visit their dentist and other hospital appointments. People had access to their healthcare they needed.
Nursing staff were responsible for making necessary referrals for any required health care needs and did so when needed. They explained they had positive working relationships with healthcare professionals. Staff had ‘champion roles’ for such areas as infection prevention and control and nutrition and said this helped them in supporting people with these identified needs.
People were supported to live healthier lives. Care records showed referrals were made to relevant healthcare professionals appropriately. Healthcare professionals’ recommendations were included in care plans to ensure staff supported people appropriately. Staff had access to relevant policies and procedures to ensure people’s health and wellbeing needs were met. This included pathways for escalation and referral routes to relevant agencies if required. Leaders explained they had regular ward rounds with the local GP practice. Leaders felt their nurses were confident in liaising with the GP's and sharing relevant information. Secure NHS emails had been created for them to help share information securely. The provider had monthly newsletters which were also sent out to partner agencies. Leaders explained social media was utilised well to promote life at the home as well as attending local community events. The electronic care planning system provided an overview of information and could highlight key information to share with staff. A messaging service was also used to share information with families. Staff meetings, including clinical meetings were held regularly.
Monitoring and improving outcomes
People told us they were happy living at The Park Residential and Nursing Home. One person said, “I feel settled and I’m able to do what I want,” another person told us, “Honestly I couldn’t say a bad thing, it’s the staff that make this place.” One person told us how their health had improved since they moved there. They told us they had been very poorly, but now they said they were, “Healthy and as fit as a fiddle.” This helped to show people experienced good care outcome living at the service.
Leaders provided an example of one service user who successfully returned home to their family after an admission to the home. This was possible because staff worked alongside the person’s physiotherapist and helped the person make improvements in their mobility. Nurses worked through checklists which ensured people’s clinical needs and medicine related needs were met. This included monitoring outcomes for people. Nurses were prompted to update and review people’s care plans as soon as any changes in need were identified.
A variety of processes were used to monitor people’s clinical needs. This included specific tools to monitor risks associated with malnutrion, skin integrity, clinical deterioration and in the detection of pain. Where people had sustained wounds, care plans were created to monitor the progress of the wound.
Consent to care and treatment
People felt their rights and choices were respected. One relative told us they felt they had been listened to and that their wishes would be respected. Other people told us they staff would ask them for their preferences and provide them with choices. For example, one person told us staff always asked if they wanted their bedroom door open or kept shut when they spent time in their bedroom.
Leaders continued to monitor and follow up with the local authority when applications had been made for a deprivation of liberty safeguard (DoLS) for a person. Staff we spoke with had an understanding of the Mental Capacity Act (MCA) and its key principles. They explained the deputy manager was responsible for completing DoLS applications but knew how to access this information in their absence. No one at the service had any conditions on their DoLS. Conditions are additional requirements that are sometimes requested as part of the local authority authorising a DoLS. Staff confirmed they had received MCA training.
Where people did not have the mental capacity to make decisions around their care and support needs, mental capacity assessments were in place. This process was in line with the principles of the MCA.