Fairways

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to safe care and treatment relating to the safe management of risks related to nutrition.

This service scored 58 (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.

Care assessments were comprehensive. Care plans were written positively and in person centred ways. People, their relatives and other professionals had been involved in developing care plans.

Staff told us the care plans contained enough information about the support people needed and how they preferred to be supported. Staff could look at care plans on handsets they carried whilst on shift.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider used clinical tools to assess people’s nutritional and choking risks. The outcomes of these assessments were not always responded to. Two people had significant weight loss but had not been referred to the relevant healthcare professionals. Some clinical observations seemed inaccurate for example, weight loss of over 15% had been recorded as less than 5%.

Some people were on modified diets, described by the provider as; pureed, minced and moist and cut up. This did not reflect best practice guidance. We have signposted the provider to further guidance.

Although people had been referred to the speech and language therapy team in relation to swallowing and choking risks, there was no guidance for staff in relation to how to support people on modified diets. Dysphagia training had not been included on the training schedule. We have signposted the provider to available training.

Nutrition and hydration charts were in place and completed by staff to monitor the intake for people identified as being at nutritional risk.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff attended a handover meeting at the beginning of their shift to ensure they were aware of any changes to people’s needs and, to plan how to support people throughout the shift.

One member of staff said, “(It is a) good staff team. We work well together, with good communication, we get on. I know where to go if I need help. Daily handovers are really good. I am updated when I’m off for a few days. PCS [electronic care record system] is new and things are getting documented better.”

We found information was dispersed widely through care records which may be difficult for visiting professionals to find the information they needed.

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 were supported to have regular routine health screening, including; chiropody, eye tests and oral health checks.

People were supported to access the doctor, hospital appointments and community health professionals, such as district nurses.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Record keeping and monitoring of people’s ongoing health needed to improve. The provider had not always taken timely action in relation to changes or deterioration in people’s health.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The provider had policies and procedures in place to support people with decision making about their care. People’s ability to make specific decisions had been assessed in line with the

requirements of the Mental Capacity Act. However, some further clarity was needed in relation to how some people had been supported. We discussed this with the provider and were assured by their response.

Where people were required to be deprived of their liberty, the provider ensured applications were made to the relevant authority in a timely manner and kept a log for when these authorisations would expire.

Staff asked people’s consent prior to offering them support and respected their responses.