Hyde Nursing 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

The rating for quality statements not looked at during this assessment have been used to provide an overall rating for this key question. People’s needs were not always met in line with good practice and care records lacked detail, personalisation and were not always accurate. Information from others, such as health care services was not always incorporated into people’s relevant care plans and peoples care records did not always demonstrate that people were having care delivered inline with their needs. There were no robust systems in place to effectively monitor people’s outcomes.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

Care plans and records did not clearly evidence that people were receiving care in line with their current needs and good practice. People’s care plans were not always reflective of health care advice and good practice guidance, and staff did not consistently maintain records to demonstrate people had their care provided in a way that met their needs. For example, records around modified diets and thickened fluid for those with swallowing difficulties were insufficient to evidence that people’s assessed needs in this area were being met. The processes for oversight were insufficient to identify or address these areas of shortfall.

Staff told us they supported people in line with their care plans. Staff had good knowledge about who was on thickener however they stated they did not record this information anywhere.

The service could not consistently demonstrate that people were receiving evidence-based care. People were not clear as to how they had been involved in making decisions about their care. However, at the time of the assessment people were happy with how staff were supporting them overall.

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.

Staff told us they knew people and would escalate concerns about people’s care needs if these were identified. Staff felt the recent improvements in staffing levels had helped to ensure they were able to support people effectively. However, the focus of care was primarily on meeting basic care needs, with less emphasis placed on achieving good outcomes and care that is tailored to people’s preferences.

People were not always clear on how staff and other services were working together to meet their needs and were not always involved in making decisions around their care.

The service had limited oversight over people’s care and treatment to monitor and drive improvement. Most people’s weights were recorded on a monthly basis. The service utilised the malnutrition universal screening tool (MUST). This tool is used to monitor weight loss and identify a score which then determines which action should be taken. This tool was routinely being used incorrectly leading to inaccurate scores being recorded. The service had not identified this issue as there were no effective systems in place to review these tools. Information from other professionals was not consistently well recorded or discussed with staff. For one person who had been referred to a dietician, the advice was recorded in a log at the back of their care file. However, their care plan around nutrition was not updated and the subsequent care plan reviews did not identify this omission. Care records did not demonstrate the advice had been followed. Staff did not consistently follow identified actions within the care plan. One person required regular monitoring of their oxygen saturation levels. This was not being completed. The service were not able to demonstrate they were following guidance and effectively monitoring the effectiveness of this person’s medication. Accident and incident reports were not reviewed by the manager in a timely way. At the time of the inspection, incidents from December onwards had not been reviewed. Incidents reviewed before November lacked meaningful scrutiny to drive improvements. For example, we identified one person who was having multiple falls often injuring their head, the care plan had not been updated to reflect this and there was no clear strategy in place to try to reduce the falls or injuries caused.

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.