Warberries 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

People’s relatives were positive about the service and told us people had improved since coming to live at the service. Assessments were carried out before people moved into the service and staff told us they had access to people’s care plans where any changes in people’s care needs were immediately updated. People and their relatives were involved in assessing and planning their care if they chose to do so. Systems were in place to ensure people received care that was in line with best practice guidance. Staff were knowledgeable about people’s care needs and received the training they needed to meet people’s needs. Staff worked with external health professionals to ensure their health needs were met. People told us they had access to health care and staff supported them with health care appointments. The service was working within the principles of the Mental Capacity Act (MCA). Staff understood people’s rights and told us about how they gained people’s consent before giving care. This was confirmed by people who told us staff gave them choices and always explained what they were doing before giving care.

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.

People who were able, told us they were involved in assessing and planning their care if they chose to do so. One person told us, “They know me really well by now. There’s nothing else they could provide. If I want to know anything I ask, and they always go out of their way to help.” People’s relatives mostly told us they and their relative were involved in care planning. One relative told us, “There was one to one communication with [name] and she seems okay, and I get the impression they did take time and trouble to look after her.” However, one relative commented that they would like more involvement.

Staff told us they had access to people’s care plans and changes in people’s care needs were immediately updated in their care records to ensure all staff were kept informed and were giving the correct care. The registered manager told us assessments were carried out before people moved into the service which included information from the local authority and/or local hospital’s discharge team.

People’s needs were assessed before they came to live at the service. This assessment informed their care plan and detailed their needs. People’s care needs were continually assessed through daily oversight of care delivery, and care records were updated monthly or when people’s needs changed.

People received care that was in line with best practice guidance. For example, people and their relatives described what action staff were taking to ensure people were supported nutritionally to maintain a healthy weight. One relative told us, “She’s on food supplements and has milkshakes. There’s a constant stream of drinks and yoghurt mid-morning. In the afternoon there is tea and cakes. No shortage of food, it’s not bad at all.” Another relative commented, “They have worked hard to get him to eat, and he has put weight back on.” Other examples people and relatives told us about included the care people received to maintain healthy skin and safely move around the service. People and their relatives told us they were happy with the care they received at the service. Comments included, “They are very good, they look after me. I can talk to them. They come in every day, all the staff are pretty good”, “I have been very pleased with the care” and “No problems at all, I am happy. I know she’s cared for and safe. The home is fabulous.”

Staff told us they received the training they needed to meet the needs of the people they supported. One staff member told us, “[Name] and [Name] are trained as the restraint and challenging behaviour trainers and that was specific to a person’s needs. The nurses and care supervisors do the oversight and competency assessments, and [registered manager’s name] oversees our clinical training.” Another staff member described receiving training on caring for people with dementia. Staff were knowledgeable about people’s care needs and how to care for them in line with best practice guidance. Staff described what they would do if a person was to fall and what was in place to prevent falls. Staff described actions they would take when people had lost weight or were having difficulties swallowing.

Systems were in place to ensure care was delivered in line with best practice guidance. For example, nationally recognised risk assessments were used to assess risk, such as, the Malnutrition Universal Screening Tool (MUST) and Water Low Risk Assessment. We saw monitoring records were in place and care was delivered in line with best practice and people’s assessed needs. Appropriate training was in place to ensure staff were informed about and kept up to date with best practice guidance.

People and their relatives gave us examples of where staff worked with other services. For example, a relative told us about the service working with the adult safeguarding team to investigate an allegation of abuse affecting their relative. They told us they were happy with how the service handled the allegation and they were happy with the outcome.

The registered manager told us since the last inspection the service had improved their relationships with health professionals and local stakeholders and now worked in partnership with them to support care provision leading to better outcomes for people.

A visiting health care professional told us they had no concerns with the service provided.

Processes were in place to ensure information about people’s care needs were up to date and shared with staff. Daily handovers were in place to discuss people’s care and care delivery, and staff had access to people’s care records. The service worked in partnership with local healthcare professionals. We saw evidence in people’s records of people being referred to a range of professionals, including dietitians, specialist nurses, physiotherapists and the Care Home Education and Support Service (CHESS).

People told us they had access to health care and staff supported them with health care appointments. For example, a relative described the health care support available, and said, “The staff organise the chiropodist, hair stylist, dentist, and optician. About 12 months ago she had a new set of hearing aids, and new glasses. If there’s any problem, it will be looked into.”

Staff told us they reported any concerns with people’s health and wellbeing to the nurse, or to the management team.

People were supported to see healthcare professionals when they needed. We saw evidence of health and social care professionals’ involvement in people’s individual care on an on-going basis. For example, people’s GP, physiotherapists and speech and language therapists (SALT).

People’s relatives were positive about the service and told us people had improved since coming to live at the service. One relative told us, “She has improved a lot since she has been here” and another relative said, “I’ve been very pleased how they have looked after her.”

Staff described to us how they monitored people’s health and care needs to ensure risks were mitigated and people received care according to their assessed needs. For example, one staff member told us, “Regular checks are done and recorded on the system and if you have not done something a red flag will come up.” Another staff member described how they monitored people’s skin, they said, “If you see any marks we go to the nurse and inform them, they will monitor and give us instructions to follow. We may have cream to apply or if it is redness we take photos, so that it can be observed. If someone has a sore, we will reposition them and they have air mattresses and if there are any issues with the mattresses we report that.”

People’s care was continuously monitored and reviewed to promote good outcomes for people. An electronic care planning system was in place that recorded care delivery and allowed staff to be fully aware of each person’s care needs. Staff were able to evidence all aspects of care given through completion of monitoring records and charts. These records were scrutinised by senior staff and the registered manager on a daily basis. This meant that any alerts indicating care had not been delivered, were identified and action taken to address this.

People told us staff gave them choices and always explained what they were doing before giving care. When we asked about consent, one person said, “Yes. They always talk to you about what they are doing. They are very good. They talk to you all the way through.”

Staff understood people’s rights and told us about how they gained people’s consent before giving care. One staff member told us, “My first responsibility is working for the residents. I need to explain to them what I am doing, be friendly to them and learn about what they like and what they need. I read the care plans and learn about their mobility, food and fluids and what is really important to them.”

The service was working within the principles of the Mental Capacity Act (MCA). Systems and processes were in place and followed by staff to ensure people were not being restricted unlawfully. Where people lacked capacity to make decisions about their care, mental capacity assessments and best interests decisions had taken place. For example, we saw mental capacity assessments and best interests decisions had been recorded in relation to the use of sensor alarm mats used to alert staff when people moved around the service unsupported. Where restrictions had been placed upon people, Deprivation of Liberty Safeguards (DoLS) authorisations had been applied for.