Cloisters 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 the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed and planned for. However, some of the information within care plans was not always clearly recorded or detailed enough. Staff were able to explain people’s needs and how they met these. Some care plans were more detailed than others. We discussed this with the manager who explained they were in the process of reviewing and updating all care plans and assessments. They had allocated dedicated time for the deputy manager and nurses to undertake this task. People using the service and their families told us they had been asked about their needs and preferences. The provider operated a system where all aspects of a person’s care plan and delivery were reassessed each month in consultation with them about their experiences.

People received evidence-based care and treatment. The care was overseen by nurses who had a good understanding of each person’s needs. They received training about different conditions and to understand about best practice nursing interventions. The manager provided clinical supervision and guidance.

All staff undertook a range of training which reflected best practice. This helped them to understand about delivering good care which met people’s needs.

People’s nutritional needs were assessed and monitored. The provider had acted when concerns were identified. People were given a choice of freshly prepared meals which were nutritionally balanced. Meals were fortified when needed to help increase people’s weight. Changes in weight were closely monitored, and the staff had made referrals to specialist healthcare professionals when required. People told us they liked the food.

Staff monitored the condition of people’s skin, had clear management plans for wounds and systems to help prevent skin damage.

The staff had effective systems for communicating with one another. They had daily handover meetings where they updated each other on any changes for people. The management team also met daily to discuss the service. The manager spent time observing care, speaking with people and staff.

Staff also communicated well with other professionals. The local health authority had a care home support team who were in daily contact with the service to discuss any clinical concerns and help monitor people’s health and wellbeing. The GP visited the service and liaised with the nurses to discuss people’s health needs.

People were supported with their health needs. These were assessed and care plans indicated people should be supported. The staff monitored people’s conditions and took action if people became unwell. People told us they were able to see external healthcare professionals when they needed. They felt well supported. Their comments included, “There are regular visits from the doctor, and they let me know when [they] are coming.” “When I attended appointments at the hospital the staff took me” and “We have someone who regularly visits to do our feet.” The provider made timely referrals when people needed to be seen by external healthcare professionals and when the staff needed advice about a change in a person’s condition.

Care plans included information about oral care. People were supported with this when needed.

Staff monitored people’s health and wellbeing, including their weight and skin condition. They also monitored food and fluid intake. Staff and managers were alerted when there was a decrease in fluid intake and people were offered extra sources of fluid. When people’s weight dropped below expected ranges, people were referred to dietitians, given extra calories and the frequency of monitoring increased. Staff recorded care interventions and when they had supported people who were at risk of skin damage to move. The management team monitored these records to make sure care was provided appropriately and safely.

People were asked to consent to their care and treatment. When people lacked the mental capacity to make decisions, the provider met with their representatives to make decisions in their best interests. The provider had obtained legal authorisations for restrictions of people’s liberties. Staff had undertaken training about the Mental Capacity Act 2005 and were able to tell us the principles of this and how this ensured people were given meaningful choices. We observed staff obtaining people’s consent before giving medicines and care interventions. They explained what they were doing using personalised communication which people understood. One member of staff explained, ‘’We give choices to people because they have capacity. If they do not, we try to give them a choice where possible and make a best interest decision when this is not possible.’’