- Care home
St Margaret's Care Home Also known as Halle Healthcare Limited Care Home
Report from 1 May 2024 assessment
Contents
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
Effective
Effective - The service has been rated inadequate. We reviewed 6 quality statements. People’s needs were not being assessed before moving to this home. Care was not always being delivered in line with best practice. The staff team were not always responsive to people’s healthcare needs. Records to demonstrate compliance with the Mental Capacity Act were not in place. The staff team did not work together to deliver improved outcomes for people.
This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Assessing needs
People told us their needs were not always assessed effectively. One person described not having the equipment they needed to mobilise when they arrived from their previous care setting. This restricted their ability to access areas of the home outside their bedroom.
The registered manager and other senior leaders were not clear on the process to follow to safely admit a new resident to the home, whilst ensuring they could fully meet their needs.
The registered manager told us they would not complete a pre-assessment or relevant risk assessments and care plans before a new admission moved into their home. This did not ensure the service was capable of fully meeting their needs. Following our assessment, the provider introduced a tool for this purpose.
Delivering evidence-based care and treatment
People told us they were not involved in their care planning. One person said, “They (management team) don't listen to us and they do not ask for our feedback.”
The registered manager did not have a good oversight of the risks linked to people's care and during this assessment. We identified serious concerns about people’s safety.
There was a lack of sufficiently detailed risk assessments and care plans. We found concerns about the safety of the premises and fire safety equipment. This showed care was not delivered in line with best practice guidance and people were at risk of not receiving safe care.
How staff, teams and services work together
People were impacted by a lack of teamwork between leaders and other staff. They told us they were not involved in their care planning, changes and reviews and were not asked if care met their personal preferences.
We found examples of people's health deteriorating, and these issues not being shared by staff or escalated to other relevant healthcare professionals. No evidence was provided of team meetings taking place.
The provider did not work well with partners, who had serious concerns about the capability of leaders and staff working together to meet people’s needs.
Handover meetings were taking place, but no records were kept and we observed this happening in communal areas where other residents could hear about other people's needs.
Supporting people to live healthier lives
People gave poor responses when asked how they were supported to live healthier lives. One person said, “They (staff) just bring me whatever the cook has made.” Another person said they had started smoking due to a lack of boredom and another person living with diabetes said they were comfort eating for the same reason.
The registered manager did not have a good oversight of the risks linked to people's care. During this assessment, we found serious concerns about people not being safe and not receiving the care they required.
Systems were not in place to effectively monitor people’s health outcomes.
Monitoring and improving outcomes
People told us the provider didn’t always monitor their outcomes. One person said, “The GP told me I should be on a softer diet, but I still just get served normal foods.”
We found examples of medical assistance and support not being sought in a timely way. People's nutritional needs were not being met and relevant healthcare professionals, such as dieticians and speech and language therapists, had not been involved.
The provider did not have systems in place to monitor and improve people’s outcomes.
Consent to care and treatment
Most people told us they did not get to make routine choices. Their feedback included, “I don’t get a choice at meals times, they just bring me the meals” and “They stop me from going out.” We witnessed a staff member putting someone to bed who told us they did not wish to go to bed.
The registered manager did not have a good understanding of the requirements of the MCA or how these applied to people living at the service who were under a DoLS.
Consent to care was not always recorded, in particular for people who lack capacity to make decisions about their care and health. We found examples of people being restricted to access the garden when they had capacity to make a decision about this. We shared this information with the local authority safeguarding team. During our visits, we could not be sure the provider submitted an application to deprive people of their liberty, in line with Mental Capacity Act (MCA) requirements.