Peacemills Care Home

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’s care plans were not always kept up to date with assessments not always completed in a timely manner. People’s care and treatment was not always effective as their needs were not always accurately assessed with them. Best practice guidance was inconsistently implemented. Staff and managers did not always implement and deliver evidence-based care. Staff were aware of people’s preferences and ensured when people required support with their health needs, relevant referrals were made.

This service scored 83 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were involved in planning their care when they first moved in but couldn’t recall any formal reviews having taken place recently. However, they felt staff asked them informally if they were happy with the care and support they received. People told us they met with staff prior to moving in and discussed their needs at length. A relative we spoke with said, “Staff came to my [relative’s] home to meet [relative] and talk about their care needs.” Another relative told us, “They came to visit my [relative] at their last care home and did the planning with me and gave me all sorts of information.”

Staff knew people’s needs well. Staff knew how to access care records and ensured they referred to healthcare professionals when needed. Staff told us they referred to specialists such as the continence team, district nursing team and specialist wound care nurses when needed.

Staff had access to documents on how to support people, however some of the assessments lacked detail to ensure staff had the correct information in how to support people safely. For example, a person with complex health needs did not have a detailed care plan in place to ensure staff had accurate information in order to support them. Another person who lived with a life-limiting condition did not have an end-of-life care plan in place to ensure their wishes and needs would be respected towards the end of their life. The registered manager told us they were aware that some care plans needed further development and they had started to make improvements. We saw some care plans had been developed to ensure people’s needs were fully assessed. For example, a person living with a catheter had a detailed assessment in place to guide staff.

Processes in place meant people did not always receive evidence-based care and treatment. Inconsistencies and a lack of detail in care plans meant managers and staff could not effectively monitor people’s needs and outcomes. For example, a person who was at a high risk of self-neglect did not have a detailed care plan in place to determine how staff were supporting them or if there had been a change in this need. This meant it was unknown if the care and support being provided was effective. Another person who lived with dementia and became distressed did not have a positive behavioural support plan in place. This meant staff did not always record when they became distressed or action they had taken to support the person. This is not in line with best practice guidance. We did find there were some processes to ensure best practice guidance was followed. For example, falls were reviewed, and an analysis was completed to determine any themes or trends. This meant actions and best practice guidance could be implemented in a timely manner to ensure people received effective care and treatment.

While the people we spoke to expressed that they were happy with their care, our assessment found some elements of care did not meet the expected standards. People did not always receive care and support inline with best practice guidance. For example, we observed people were not always supported with their repositioning and continence needs in line with the best practice guidance. People did tell us they had positive relationships with staff and they felt confident staff supported them correctly and in line with their wishes.

Best practice guidance was inconsistently implemented. Staff and managers did not always implement and deliver evidence-based care. For example, we found many people who lived with a cognitive impairment did not have specific assessments in place to detail support was being provided in their best interests. We found the management team were aware these were missing for many people but had not taken timely action to rectify this. The management team explained they had picked this up in an audit but did not provide assurances as to why no action had been taken. We did however find other areas of care where best practice guidance was in place. For example, best practice nutritional guidance was implemented including nutritional screening tools for those deemed at risk of malnutrition, staff also utilised specialist utensils to ensure people’s independence was promoted.

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.

Staff understood people’s needs and how to support them to access health and social care support if needed. The management team gave us several examples of referring to external agencies such as speech and language therapists and dieticians. Staff told us they completed training to ensure they were aware of changes in presentation of certain health conditions such as diabetes and dementia. This meant staff were able to recognise and act if a person became unwell. Staff told us they worked effectively with the pharmacy and Doctors’ surgery to ensure there were no delays in people receiving any medicines or potential treatment.

People told us staff supported them to access health appointments as needed. One person said, “Staff will book any appointments that we need doing, no problem,” and another said, “I’ve seen the doctor three times and had a visit from the eye specialist.” A relative we spoke with told us, “My [relative] can see a doctor and chiropodist and they also arrange an optician or dentist.” People told us they were supported to undertake exercise to promote their health and wellbeing. A person told us, “I do exercise at least twice a week.” All the people we spoke with felt confident staff would contact the correct professional when needed.

Records were kept of when health professionals visited, and what advice they gave people. For example, we reviewed a care plan where professional advice had been implemented. This care plan instructed staff to use a certain chair for a person and we observed the person to be sat in the specialist chair. Staff recorded people’s daily wellbeing. This allowed staff to monitor people’s overall well-being. For example, we reviewed notes where a person had not drunk much, it was recorded, and the following staff ensured they encouraged the person to drink. They monitored the person to ensure they remained well. We also reviewed records following a fall. A person was monitored, and a healthcare professional contacted for advice. A body map was completed to identify any potential injuries. Staff recorded people’s daily food and fluid intake where they were at risk of malnutrition. Where needed people were referred to a dietician for dietary supplements. This protected people from the risk of malnutrition.

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.