Queens Court

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

We found care plans did not always fully reflect people's needs, and information arouind medical risk assessments were contracdictory. Falls risk assessments lacked guidance, and a person with a pressure ulcer had no risk assessment. These failings are a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Staff were aware of the importance of seeking consent from people they supported, however, mental capacity assessments were not always completing in line with the Mental Capacity Act 2005. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2024. Need for consent.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received mixed feedback in relation to people’s experience on assessing their needs. Some people told us they were involved in planning of their care needs and risks. One person told us, “I was asked some questions when I came here.” However, other people told us they had not received enough information in relation to the care their relatives were receiving and thought not enough questions were asked of their loved ones in relation to their support needs.

The registered manager told us that care plans and risk assessments were kept under regular review. They showed us care records and risk assessments which were held on an electronic care planning system. The activity coordinator told us they were currently completing “This is me” documents with people and or their family members. However, we noted that most of these were not completed and or detailed. The deputy manager told us the service had positive links with community services (district nurses, community mental health teams.) They described how the community mental health team provided positive advice and support for people who may present with distressed behaviour. This worked to help to develop strategies to support individuals with their needs.

Care plans and risk assessments were developed within the providers electronic care planning system. We found some plans had conflicting information. One plan stated a person did not require a referral to the community mental health team (CMHT), the same plan went on to state the person was currently under the care of CMHT. Another plan stated a person should be tracked and recorded to prevent them going into other people's rooms. However we observed this person received bed care and did not have capacity to enter anyone's room. Medicines care plans were contradictory. One person’s care plan stated they were compliant and able to take medication independently when it was administered. It then stated they were compliant and able to swallow medication, when medication is put in the mouth and a drink given with significant assistance. The care plan was not clear on the correct way to support the person with their medicines. Another person’s ‘falls risk assessment’ lacked detail and guidance for staff to follow to ensure their safety. There were no details documented for the use of equipment in place, for example a sensor mat. Another person had a pressure ulcer, however, there was no risk assessment for the management of pressure ulcers for this person. The person’s repositioning chart only stated how they were supported by staff with personal care and transfers, with no details and guidance documented about the person’s wound or wound management. These issues are in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We observed people having lunch in the dining area/lounge and in their rooms. People were given choice on what they wanted to eat and were shown sample plates which made people’s choices easier for them. Some people were supported by staff to eat pureed meals including yogurts. People were supported to eat and drink by staff in an unhurried and caring manner. We received mixed comments in relation to meals received. One person said, “They could have better desserts.” Other comments about meals were, “I like the food here.”, “It’s not baby food.”

The registered manager told us they sought advice from speech and language therapists regarding people’s eating and drinking and support needs. They showed us speech and language assessment records and we saw these were displayed in the kitchen advising staff how to support people with eating and drinking. However, people’s nutrition and hydration care plans did not always reflect their assessed needs and risks. The chef was knowledgeable of people’s dietary needs. They told us about people’s food preferences and cultural requirements. For example, people’s vegetarian and pescetarian and halal meal preferences. They showed us information in the kitchen which detailed people’s individual dietary needs for example some had allergies and had modified textured diets where they were at risk of choking.

Care plans did not always reflect current guidance and recommendations made by health professionals in relation to people’s dietary needs and risks. However, care plans included people’s nutrition and hydration needs, appetite, allergies, food intolerances and cultural preferences.

People had access to health care professionals when they needed them. However, records showed that staff communication and referrals to health and social care professionals were not always effective or made in a timely manner.

The registered manager told us they worked with various professional teams to support people with their care needs. These included physiotherapists and speech and language therapists. The community mental health team regularly attended to people at the home to review people’s needs care and support needs. However, referrals to health and social care professionals were not always made in a timely manner.

A visiting professional told us, the staff know people well and always have the appropriate records ready for me when I come here. The staff are competent and follow any advice I give them. A GP told us they attended the home fortnightly. Between visits the home could arrange for the practice nurse to review people needing an emergency appointment. They said staff and managers managed the people’s medical needs well. The GP told us the activity coordinator had a positive impact on people using the service.

Staff worked in partnership with GP's and other health and social care professionals so that people had access to health care support when they needed it. The contact details for external healthcare professionals such as speech and language and occupational therapists were held in people's care records. However, people’s care plans did not always reflect their assessed needs and risks. We discussed an incident with the registered manager where a person had left the premises and sustained an injury. The registered manager told us they had ensured the safety of the person and made appropriate changes to the home environment but had failed to raise the concern as a safeguarding concern and had failed to refer the concern to the local authority and CQC as required.

People had access to health care professionals when they needed them. However, records showed that staff communication and referrals to health and social care professionals were not always effective or made in a timely manner.

The registered manager told us they worked with various professional teams to support people with their care needs. However, records showed that staff communication and referrals to health and social care professionals were not always effective, or made in a timely manner.

A visiting professional told us they had some concerns about wound care and management at the home. They told us they would raise this with the registered manager during their visit and their manager when they returned to their office. Records showed the home worked with professionals such as, GP’s and community mental health teams. People's health needs were recorded within their care plans detailing any support required from staff to meet their needs. Referrals to additional support services such as speech and language teams and dieticians were made by staff when required. However, we found that referrals were not always followed up and records were not updated when required to reflect people’s needs.

People had access to health care professionals when they needed them. People did not comment on monitoring and improving outcomes. However, records showed that staff communication and referrals to health and social care professionals were not always effective, or made in a timely manner.

The registered manager told us they worked with various professional teams to support people with their care needs. The deputy manager told us the home had links with community services such as district nurses and community mental health teams. They described how the community mental health team provided positive advice and support for people who may present with distressed behaviour and help the home to develop strategies to support individuals with their needs. Records showed that staff communication and referrals to health and social care professionals were not always made in a timely manner. Records also demonstrated that staff failed to follow up referrals made to ensure people's health needs were addressed. Staff failed to seek guidance from medical professionals to guide them in managing people living with health conditions, for example, diabetes or asthma.

Records showed the home worked with professionals such as, GP’s and community mental health teams. People's health needs were recorded within their care plans detailing any support required from staff to meet their needs. Referrals to additional support services such as speech and language teams and dieticians were made by staff when required. However, we found that referrals were not always followed up by staff and care records were not always updated when required to reflect people’s needs.

A person using the service told us their relative had helped with planning for their care and consent to treatment. Another person told us, “I wish they had more information on my situation.” A relative told us, “I have asked for help with understanding the care of my loved one, but I have not received any information.”

The activity coordinator told us they were currently completing “This is me” documents with people and or their family members. However, we noted that most of these were not completed and or detailed to ensure people received person centred care and treatment.

Staff were aware of the importance of seeking consent from the people they supported and had received training for The Mental Capacity Act 2005 (MCA). However, people’s consent was not always sought when planning for their care and support needs. Mental capacity assessments had not always been completed in line with the MCA where required and documented within people’s care plans. This was a breach of Regulation 11 Health and Social Care Act (Regulations 2014) Need for consent.