Bishop's Cleeve 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

People’s needs had been identified and assessed; however, the management of some people’s risks had not been accurately recorded in line with their care needs assessment and recommendations from health care professionals. Through their own auditing system, the interim manager was aware of the inaccuracies in people’s care records and had obtained additional support to improve people’s care records in line with best practice. The assessment of staff skills to support people appropriately was also being addressed as a priority. People’s feedback about their care was mainly positive.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff stated people's care records were not always current but information about people’s care needs was shared with them in the staff hand over meeting at the beginning of each shift. Communication amongst the staff helped to ensure current information about people was shared amongst the staff team. The interim manager explained plans were in place to reassess and review each person’s care plan with them to ensure they were current and accurate.

One person told us their risk of skin breakdown had been assessed and they had been provided with specialised pressure reducing equipment. The person told us staff also monitored the condition of their skin when they applied the prescribed barrier cream. This person’s safety had been reassessed with them, following a fall. They had been provided with a pendent alarm which had provided some reassurance to them in case they fell again. Another person told us staff assessed their mobility needs before they supported them to move as there could alter. Relatives told us people were reviewed when their needs changed and where needed their care had altered and they had been informed about this.

The provider’s policies set out the framework of good practices in assessing and recording people’s personalised care and treatment. However, these practices were not fully reflected in people’s care or related care records. For example, we looked at 5 people’s care plans and found care plans contained contradicting and missing information. For example, in relation to information about 1 person’s pressure relieving equipment to protect their skin and, in another person’s, dental hygiene requirements where these were not recorded in the person’s care plans. This meant staff did not always have the guidance they required to manage people’s risks and personal care needs.

Staff had received training on how to support people, however from our conversations with staff, it was clear not all staff understood their training or how to support people’s specific needs. The interim manager stated they were planning to carry out competency assessments with staff, in key areas of risks, such as the management of people’s diets and mobility needs. This would ensure staff’s training and understanding of people’s risks were fully reflected in their practices. The interim manager recognised the importance of using evidence-based guidance and tools to help monitor people's needs. They were responsive to our feedback and had plans to introduce national guidance and localised agreed practices, such as post falls monitoring and to train staff on how to identify less obvious signs’ that people were becoming unwell.

People told us they felt they were looked after well and were involved in decisions about their care. They felt staff provided them with choices and were aware of things which were important to them. This information was mainly reflected in their care plan.

People’s care records did not always follow evidence-based guidance. We looked at 2 people’s care and risk plans regarding prevention of falls and determined their assessments had improved. However, we found inconsistencies in how staff supported people after they had experienced a fall and, in the guidance recorded for staff in people’s care plans. Managers and staff were not fully aware of national and local post falls guidance. This meant staff did not always have appropriate guidance available to support them in the management and support of people after they had experienced a fall. This placed people at risk of not receiving the most appropriate care. The interim manager agreed to seek additional guidance and support from the local authority.

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.