Cressington Court Care Home

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• 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

We assessed 2 quality statements in the effective key question and found areas which required improvement. The scores for these areas have been combined with scores based on the rating from the last inspection, which was requires improvement. Our rating for this key question remains requires improvement. We identified two breaches of the legal regulations. Systems to ensure people's needs were robustly assessed were ineffective. Care plans lacked the necessary person centred detail to guide staff in meeting people's needs and preferences. When the provider had identified issues with their pre-admission processes, there was no evidence to show the necessary action had been taken to improve this area. This exposed people to a risk of their care needs not being met. The providers systems to ensure people's nutrition and hydration needs were met were inadequate. Some people were not receiving a diet consistent with their assessed dietary needs and some people who required a modified diet to prevent weight loss were not always receiving this.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were involved in discussions about their care needs. However, the majority of people we spoke with told us they had not seen their care plan. Comments included, "Not actually seen it. They went through a lot of things with me and my family. Checked things with me, what things I like to do and the things I need the most help with." While people generally indicated they were involved in initial discussions about their care, our assessment found elements of care did not meet the expected standards in relation to assessing peoples care and support needs.

Staff told us people were not admitted safely to Cressington Court Care Home. Comments included, "It doesn't feel safe when people are being accepted into the home", "feels like people are not assessed properly" and "I feel I am putting my job at risk because I don’t get time to do some of the assessments. It needs to be better." The provider had recently transitioned to an electronic care planning system. Staff were honest and described how the electronic system lacked the necessary information about people's needs and risks. Comments included, "[Electronic care planning system] is missing information, it is because we are still figuring it out. We do get training, but it's hard to implement. It is not currently being used to its full potential."

People's needs were not robustly assessed and care plans lacked the person centred detail to guide staff in meeting people's needs and preferences. Care plans did not always contain details about the person’s preferences, life history, hobbies or interests. Where people were unable to communicate their needs, there was no evidence other strategies had been implemented to ensure their views were incorporated into both care plans and risk assessment. Care plans were not reviewed in a timely manner or when people’s needs changed. Since January 2024 a care plan audit had been completed for just 4 out of 53 people. 2 of the audits identified a lack of pre-assessment information however, the action plans attached to both audits were blank. Therefore, there was no evidence to show the necessary action had been taken to improve the quality and safety of the admissions process. This exposed people to a risk of their care needs not being met.

We could not collect enough evidence from people to accurately score the people's experience evidence category relating to delivering evidence based care and treatment.

The provider told us staff delivering care were not always responsive to people's changing needs and did not escalate any changes so that the necessary referrals to external health professionals could be made.

Systems in place to ensure people's nutrition and hydration needs were met were inadequate. Some people were not receiving a diet consistent with their assessed dietary needs and some people who required a modified diet to prevent weight loss were not always receiving this. Weight monitoring records were not well maintained and we were not assured sufficient action to refer to health professionals was taken when people had experienced a significant weight loss. Nutritional care plans were not updated to reflect changes in people's needs. For example, for a person who had been assessed by health professionals as requiring a diet based on soft and bite sized foods, their care plan stated they required no modifications to their diet.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.