Southborough 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 consistently good, and people’s feedback confirmed this.

This service scored 62 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People and relatives told us they were involved in the assessment and planning of their or their family member care. A relative told us, “The involve us in everything concerned with [family member].” A staff member gave us an example of how they prepared for a new admission. They said, “A recent admission we involved the district nurse to obtain a pressure relieving mattress, we also referred to the mental health team and the dietician. This was based on the information we gained during the assessment.” Staff told us they had access to care plans which contained detailed information about people’s assessed needs and their preferences about their care. A staff member told us, “We communicate with people about their care plan, people and relatives tell us about their preferences and risks and we make sure this is recorded.” People’s needs were assessed prior to moving into the service and regular reviews were undertaken to ensure information was kept up to date.

The service did not always deliver people’s care and treatment in line with current national guidance and best practice. A professional told us whilst staff knew people well, they were often dismissive of the suggestions they made particularly when responding to people’s distressed reactions. Staff often stating that every therapeutic intervention suggested had already been tried and did not work. People and relatives told us people received the support they needed to meet their needs. A relative told us, “I do think they always keep an eye on [family member], they have a heart condition and staff are straight on the phone to the GP if they are worried about [family member]. Staff knew people well and knew how to meet their needs. A staff member told us, “We have nurses come in and deliver additional training such as stoma care and pressure care.” Records showed evidence of the provider working with health care professionals to ensure people’s health needs were met.

The provider worked well to ensure information provided was current. However, we received mixed feedback from partner agencies about advice offered to staff as reported in the well led section of this report. Staff were able to access care plans so they had up to date information about people’s needs. The service had good links with other professionals involved in people’s care. People and relatives confirmed they were supported by a consistent staff team.

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. People and relatives told us they or their family members were supported to access any health services when needed. A person told us, “Staff are very kind they will call the GP for me if I need it.” A relative said, “They have a weekly ward round with paramedic, I actually spoke with the GP.” Staff told us they have good relationships with visiting professionals who they kept updated in relation to people’s health. We did note a person who had put on a significant amount of weight which the registered manager told us they were contacting a dietician for advice.

The provider did not always routinely monitor people’s care and treatment effectively to continuously improve it. Systems were in place to monitor people’s weights, food intake, fluid intake and skin integrity. However, records in relation to people’s fluid intake were not always consistent with targets set within their care plan. There was no evidence staff took action when fluid levels dropped below recommended targets or gaps in records were noted. Whilst we observed staff encouraging fluid throughout the day improvements were needed to record keeping. Staff understood what actions they would take if they noted signs of deterioration, but records did not reflect the action taken particularly with fluid monitoring.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The 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 when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The service worked within the principles of the MCA. People were involved in decisions about their care. Capacity assessments and best interest decisions were completed when additional restrictions were in place, such as the use of bed rails or monitoring alarms. Staff had completed training in this area and understood the principles of the mental capacity act. A staff member told us, “Everyone has choices, they will decide differently. If they are not able to decide for themselves, we reassure them and talk with them, we use soft words to help them understand.”