Country 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 were not always involved in decisions about their care, there was no evidence people were involved in the assessment process and reasonable adjustments were not always carried out to meet the needs of all people in the home. Assessment tools were not used effectively and there were issues around recording of food and fluid balance charts and re-positioning charts. Assessments were not up to date and did not reflect people’s current needs. Consent was not always sought for the care and treatment of people. Capacity assessments had not always been completed if a person’s capacity was doubted and where a person lacked capacity the provider did not act in accordance with The Mental Capacity Act (2005) for example best interest meetings were not held for people who it was deemed did not have the capacity to make the decision for themselves. This was a breach of regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) 2014. There were limited evidence assessments had been reviewed and evidence-based practice was not always used when planning people’s care.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were left in bed for long periods of time and were not re-assessed and buzzers were out of reach. One person was left alone in their room with no stimulation and doors were observed to be closed. A relative told us “At times [Person’s name] has missed their lunch, no one comes to see them.” One person said, “I am always in bed unless there are activities on.”

Staff told us people’s care was reviewed; however, they were not able to explain how this would happen.

Although care plans had been reviewed, they had not been updated with current needs and did not provide the right information for staff to care for someone safely and meet their needs. People did not have life histories within their care files to support staff to understand and acknowledge the people they cared for.

People were not cared for following evidence-based practice and good practice standards. Most people had not had their likes and preferences recorded or had any updated needs assessments. In most people’s files there was no life history documented or any documentation in ‘About Me’. A family member told us [Person’s name] often gets their meals missed because they leave them in bed all day with the door shut, when we are here, we must check they have had something to eat.

People were not always involved in their treatment plan although staff told us they tried to keep on top of things and checking things out they appeared to lack understanding of evidence-based practice. One staff member said, “We don’t deal with anything like that, we just get told what to do.”

People’s nutrition and hydration needs were not always met. People waited a long time to be supported with eating, and the dining experience required improvement. Most people who were independent at mealtimes preferred to eat alone in their rooms. Mental Capacity Act processes were not followed, and staff made decisions for people who lacked capacity in their best interests without following the correct legal procedures. Monitoring forms were not completed and people who were a high risk of pressure damage were not re-positioned as required to prevent further damage.

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.

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.