Finch Manor Nursing 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

Our rating has changed from inadequate to requires improvement. We found one breach of the legal regulations. Outcomes for people were identified and monitored, however, records to monitor care delivered needed to improve as they failed to demonstrate sufficient provider oversight. People were admitted safely to the service and their needs appropriately assessed. Accurate risk assessments and care plans were in place. Records demonstrated when people had consented to aspects of their care. When a person could not consent, capacity was assessed, and decisions were recorded to be made in their best interests. People were supported to access the services of other healthcare professionals to ensure their physical health needs were met. This included arranging and attending appointments with people when appropriate.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received an assessment of their needs prior to moving into Finch Manor Nursing Home.

Staff were able to describe the referrals and admissions process in place. Staff were able to explain the process relating to completion of care plans and sharing with the wider team.

Systems were in place to ensure people’s needs were fully assessed before moving into Finch Manor Nursing Home. The risk assessments and care plan of people recently admitted demonstrated this. For one person however, we identified some detail needed to be updated as their needs had changed since they had moved into the service and one aspect of their risk assessment contained conflicting information, which made it confusing to read. We raised this and were told the care plan would be updated.

People told us they received care which was in line with their specific needs.

Care staff confirmed they had received training and guidance around people’s specific care needs and described ways of supporting people which were in line with best practice. For example, staff were knowledgeable about peoples eating and drinking needs and the risks associated with this. Kitchen staff had accurate information about this aspect of people’s care.

Systems were in place to support and inform new staff and agency workers about peoples eating and drinking needs. Discrete information cards were held on each unit for staff to use as a prompt when supporting people. Care plans had been developed with guidance from other professionals. However, some risk assessments needed to be updated to reflect when a person declined to follow this guidance. For example, one person had been recommended by a speech and language therapist to eat only food of a pureed consistency. However, the person chose not to follow this advice and instead would eat soft sandwiches. The risk assessment reflected their choice but was insufficiently detailed about the risk this posed. This was immediately updated when we highlighted this. Another person chose not to be weighed but required a pressure relieving mattress to protect the integrity of their skin. These mattresses are most effective when accurately set based on the persons weight. Further exploration was needed to ensure the mattress was appropriately set for the person. We shared this with the manager who told us they would take appropriate action.

Family members told us they felt involved in people’s care. Comments included, “The staff do involve me by keeping me informed about [Name’s] care” and “I make it my business to be involved in [Name’s] care as they have several health issues.”

Staff described how they worked effectively with other agencies and were able to name those agencies they worked with to ensure people’s needs were met. Staff described attending daily huddles and flash meetings to share information within the team.

We received mixed feedback from partners about how effectively staff worked with them to ensure people’s needs were met. Whilst some felt they had positive and improving working relationships, we received feedback from one professional who expressed frustration of the ongoing management changes within the service. They fedback this had created situations when staff did not follow their professional advice as the information had not always been shared amongst the team.

Systems were in place to demonstrate when staff had interacted with other agencies to effectively support people. Information was recorded in daily care notes, as well as any advice or guidance provided. For example, records had been updated following medical appointments, when other healthcare professionals had been to visit a person or when referrals had been made for external support for a person.

People confirmed staff supported them to access health appointments and other health services when needed. We were told, “Yes, I see doctor for a check-up. The home arranges the appointment and either my sister takes me, or the home gets a cab for me” and “The district nurse comes and does bloods, and they will send results to doctors.”

Staff confirmed the process they would follow if a person was unwell. Staff gave examples of how they encouraged people to maintain their physical wellbeing. For example, by offering high calorie drinks to promote weight gain. The activity worker described the activities they encouraged people to participate in, such as chair exercises and gardening were designed to encourage people to move around and maintain their mobility.

Staff recorded any medical appointments made for people through the daily care notes and their outcome. During our assessment we observed people being supported to access health appointments at the local hospital. Risk assessments and care plans identified individual needs regarding living healthy lifestyles and how to promote this whilst respecting personal choices. When a person was at risk of self-neglect, this was also identified with detail about how this risk can be mitigated.

One family member described how they coordinated with staff when they brought food into the service for a relative who was diabetic, so it did not affect their wellbeing. They said, “Staff have to be aware and monitor what [Name] eats. If I am taking [Name] some food in, I will phone and tell them not to give them dinner, and they will adjust their care based on that. They are always very accommodating.”

Staff described ways in which they monitored and improved outcomes for people. For example, handovers were used to share information of concern or key risks with each other. Staff told us they recorded the care they provided through the providers care planning system. One staff member described how they worked regularly on the same unit so would recognise if peoples care was appropriate, or not. They told us, “I observe. I know the residents on my unit.”

Management oversight of the daily care provided to people needed to be more robust. For example, some people were at risk of dehydration. Staff were not always consistently recording an accurate record of the amount of fluid a person was offered or consumed each day. One person needed regular checks throughout the night due to a risk of falls. Records were inconsistently completed. Another person needed regular repositioning to avoid the risk of skin breakdown and pressure areas developing. This was not consistently recorded. It was identified the person could refuse care, but any refusals were not recorded. Other people’s care was consistently recorded however, these shortfalls in recording meant we could not always be certain people’s daily care outcomes were being sufficiently monitored or improved.

People told us staff sought their consent before providing them with care. One person told us, “The staff are respectful and ask me before they help me.”

Staff told us they always requested consent from people before providing personal care. Staff demonstrated an understanding of a person’s right to refuse and described the actions they would take if a person refused care. we were told, “They have the right to refuse. I would check the care plan and risk assessment. Give them time and explain what I want to do” and “I would document that we tried, give them time and try again.” One staff member described an example of a person who was reluctant to wash their hair and how they had been creative in gaining consent. They told us, “There is one [person] who will not let carers wash their hair, but they will let me, so I have developed a weekly routine where I take them for a little salon experience and wash their hair. They love it.”

At our last inspection we found decisions made about people’s care had not been in line with the Mental Capacity Act 2005 (MCA). At this assessment we found systems had improved however, where people faced restrictions, these were not always included in applications to deprive a person of their liberty. For example, capacity assessments were in place to gain consent for support with care, medicines and to share personal information. However, several people required sensor mats or bed rails to keep them safe from the risk of falls which were not identified in DoLS applications. We raised this and the regional manager who took appropriate action.