Wendreth 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

People told us they had input into care plans and that likes and dislikes had been adhered to. We saw evidence that people's needs were regularly reviewed, and the home liaises with other services when needed. We saw evidence that the home is open to innovative approaches to improve quality of care including taking part in research studies and inviting external teams to deliver training. We observed staff working well together and sharing information in clinical meetings. We found care plans included planned outcomes for people and how to achieve outcomes. We observed some areas for improvement with the lunch service which the provider immediately addressed.

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 and their relatives confirmed that they had input into their care plans and that likes and dislikes had been included. All were happy with the way staff supported them with their mobility and personal care. One relative told us that when their family member moved in there was initially lots of conversation. They told us that staff set out a full care plan, ensured the needs were recorded and the plan was put into practice.

The registered manager told us people's needs were assessed daily to take into account people with varying needs. They told us the process when people moved into the home and how information is gathered to ensure the staff can meet their needs. They explained that documentation was completed prior to admission and then time was spent with the person to find out more about their culture, routines and what would make the home familiar. Staff told us they were made aware of the needs of people when they moved into the care home, following the pre-admission assessments completed by management. Staff were encouraged to get to know new people and assist them with their transition into the care home. Staff continued to involve people in their care planning journey for routine reviews, and when care needs specifically changed. Staff shared important updates regarding people, and their needs or change in health during handovers and clinical meetings. For example, 1 staff member told us, '[People] will tell me what they want, I can also read their care plan about [their needs], and what they like.' Another staff member told us, 'We have a handover at the beginning of each shift, and at the end. The provider had recently implemented a paper handover document, which is working well, and others can also refer back to it. It captures any concerns or specific care needs.'

There was evidence that care plans were reviewed each month but also as and when required. Religious, spiritual and cultural needs as well as life history and social needs were recorded clearly showing involvement from the person. Care plans focused on both physical and mental health needs and there were individual care plans when required for example for diabetes management. Communication was considered regarding people's preferences and referred to using technology to aid communication and maintain relationships. Care plans interlinked with each other for example, the communication care plan referred to how a person's dementia diagnosis had impacted their communication. We found there were gaps in some care plans about people’s interests and hobbies. However, the dementia champion had been completing ‘This is me’ documentation with people and people close to them which had helped to get to know the people with a dementia diagnosis. 'This is me' is a publication by the Alzheimer's society which records details about a person who cannot easily share information about themselves. Care plans included an identified need, planned outcomes, how to achieve outcomes, risks and reviews. There was information about other services and professionals involved in people's care and equipment used. Care plans made links between people's physical and mental health. For example, people who suffered anxiety during support with personal care and how staff can provide reassurance. We found care plans included guidance for staff on when to take proactive action. For example, signs of moisture lesions and when to contact the district nurse. However, there were times when care plans contained conflicting information. For example, for 1 person it stated they would need support with repositioning every 2 hours but then elsewhere 4. We found there was conflicting and out of date information on care plans regarding pressure sores and different information about people's mental capacity.

One relative told us that their family member had some dietary concerns so they discussed different meal options with the registered manager who said they would arrange for the cook to talk to the person and relative. In regard to nutrition people we spoke to had no issues with the quality and variety of food. One relative told us that food can be cold but the home had completed a lessons learnt exercise around this and recorded actions taken. People told us they had a residents meeting informing them what the home offers and a chance to speak up. Relatives also had the option to attend a meeting and told us they were involved in the care planning process. One relative told us that their family member had always had the same breakfast routine which was maintained at the home. Relatives told us that the 2 meal options at meal times were put on a blackboard in the dining room.

The registered manager and regional director told us of research opportunities the care home has been involved in. These are specific to the provider and the needs of people who currently reside at the care home. The registered manager told us they had monthly meetings with the cook where they reviewed people's malnutrition needs and any weight changes and then made an action plan. For example, they have liaised with a person's dietitian to consider different food options. The registered manager gave examples of how staff had resolved concerns regarding people's nutrition. This included when they recognised that someone was anxious during mealtimes due to where they were sat in the dining room. When staff suggested another table this improved their wellbeing and their appetite. The registered manager explained that they have 'Resident of the day' when the head of department will check how the person is and ask if there is anything extra that can be put in place to support them. They also contact the family for their feedback.

The care home used specific support tools to enable person- centred care. Staff showed us they used 'This is me'. We saw evidence that the home is open to innovative approaches to improve quality of care, including taking part in research studies and inviting external teams to deliver training. Care plans ensured that care and treatment was evidence based. We found consideration was given to medical diagnoses, medical history, previous and current treatment, staff training and professional input. The clinical team meeting minutes we viewed referred to dementia strategies. For example, a discussion was recorded regarding purchasing red plates to see if this could increase people's appetite. This is because studies have shown they can help people living with dementia see their meals.

One relative told us it was a positive experience when their family member moved from another service to Wendreth Court. They told us that the deputy manager came and met with them, they had a good meeting and a full assessment was completed jointly and they were shown around the home. Two people had concerns regarding communication from staff when they enquired about equipment and continence products. The registered manager was able to provide evidence of assessments completed, referrals made and stock levels. However, they recognised that some people may require further reassurance.

Staff told us people received good support from healthcare partners. This included the prompt referral processes, in person appointments and visits. Staff attended appointments with people where they took place outside of the care home (or family members attended if they wished) and appropriate documentation was prepared by staff to assist with transition, such as hospital admission documentation. For example 1 staff member told us, "The District nurses are really good, if they are here and you are worried about a person, they will see them. We don't need to wait for a referral to be reviewed."

We saw feedback from a local authority brokerage officer praising the registered manager for their response to new referrals. However, feedback from partners was limited due to them having minimal involvement with the care home so far.

We saw that appropriate documentation was prepared by staff to assist with transition, such as hospital admission documentation. Each person had a paper folder with important information including hospital discharge summaries, local authority assessments, appointment letters. Evidence of pre-admission assessments and referrals were seen in care plans. If other teams had been involved during an admission then this was recorded, as well as any liaison with hospital discharge planning. We saw evidence of referrals to physiotherapy and occupational therapy services and these referrals as well as appointments and health updates were shared in daily meetings at the home. The home had a 'Medication on Transfer or Discharge Tracker' which helped to ensure safe discharge planning.

People and their relatives told us they were involved in care planning and that they had choice and control regarding their support. People and their relatives told us that staff were approachable, and they could ask them questions and have discussions about their care. People were happy with the meal choices and relatives told us that since the appointment of an activities coordinator there were more activities to improve people's wellbeing. One person was overheard talking about their trip to the pub and love of real ale with the activities coordinator.

Staff told us they had good communication within the team to ensure the individual needs of people were met. Staff were knowledgeable of specific health needs and how they can support and promote well-being in their roles. Staff knew who required fortified diets and specific assistance from staff at meal times. The kitchen staff were aware of who required a fortified diet, a specific consistency of food, or diabetic diet due to their health needs. For example, the chef told us, 'We have good communication with the care team, and flash meetings each day so we are kept aware of what [people’s] individual needs are.' Staff told us they were guided by the persons wishes and choices, and also by the care plan guidance available.

People were supported to remain active and healthy by the culture at the care home. This included physical activities, where people could participate, such as yoga, or accessing the local community with staff. The head of department and clinical meetings allowed for continuous reviews to take place and communication about individual needs. For example, where people may be losing weight, the kitchen staff were aware of the need for fortified diets to be provided, or that a dietician may become involved and provide specific guidance for staff to follow. Access to the GP or Nurse practitioner was facilitated by the service. Staff told us they felt supported by the reviews which are completed, and their ability to request people are reviewed if their health appears to change.

Relatives told us that staff were motivated to consider options to improve the wellbeing of their family member. For example, 1 relative said that their family member's appetite had reduced so the registered manager arranged a meeting with the chef. Another relative said that their family member wasn't participating in any activities so was in discussion with the activities coordinator about activities they may enjoy.

Staff told us they had monthly meetings with the chef where they reviewed and discussed people's nutritional risks. People had monthly reviews of their health and wellbeing when staff spoke to them about any additional support they needed. Feedback was gathered from the person and their family. Daily staff clinical meetings enabled an ongoing review of people's needs and ensured monitoring of people's care and treatment. Meetings were also an opportunity for reviews following any incidents and updates after appointments.

People's care plans were reviewed each month or more frequently if required. Care plans included identified needs, planned outcomes, how to achieve outcomes, risks and reviews. There was information about other services and professionals involved in their care and equipment required.

People told us they were checked often and could ask for anything they needed. One relative told us they thought their family member had choices and another said staff let their family member choose their clothes. They said there was always a choice of food and people's independence was respected.

Staff said they had completed training which included consent and person- centred care. Furthermore, 1 member of staff told us, 'I always ask [people] before I do something, they need to give their consent. Some decisions [people] can make easy, such as what to wear. Other decisions may be more difficult, so wording and time is important for the person.'

Staff worked in line with specific policies, procedures and best practice at the location. CCTV was in operation, this was compliant with requirements, and consent was gained from people as part of their admission process. Staff worked in the best interest of people and ensured consent was gained at every opportunity when providing support. Consent forms were viewed in care plans and Lasting Power of Attorney information and DNACPR forms were held securely. Deprivation of Liberty Safeguards were in place when required and a central log of all applications. Mental capacity assessments were completed when required however, they could be very limited and we saw conflicting and unclear information about people's capacity in some care plans.