Elliscombe House

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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

During the assessment we found that the effectiveness of people's care, treatment and support did not always achieve good outcomes or was inconsistent. Feedback from people was mixed in relation to the support received from the nursing staff working within the service. We found that due to the lack of clinical leadership at the time of the assessment, the support people received to liver healthier lives was inconsistent.

This service scored 71 (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.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.

People spoke about the use of agency nurses. The told us that the care received from these staff was not always as good as from the permanent nurses. One person said, “We have to rely on agency nurses; this isn't as good. They don't know us as well.” Another person told us, “Agency staff at night can be a problem. I have to tell them the care I need as they don’t seem to know.” People told us they were supported to manage their health, care and wellbeing needs. One person said, “I’ve seen the doctors once since I’ve been here. I go to my hospital appointments with my daughter. That’s my choice.” Relatives thought people’s health care was well supported. One relative said, “I think they’re good at that, they don’t hold off calling the GPs or anything. They keep me informed.”

All permanent staff appeared to have a good knowledge of people’s needs and the care they needed. The deputy manager said they had made referrals to other health professionals such as a speech and language therapist, dietician, the diabetes specialist nurse and tissue viability nurse. They also told us a physiotherapist was due to start at the service soon to support people with mobility and other needs.

There was a clear lack of clinical leadership. There was no designated clinical lead in post and a lack of effective communication between nurses who were not always permanent members of staff. This meant important clinical information about people had not been handed over. There was no written handover in use between staff. This meant the staff starting a shift were reliant on staff from the previous shift handing over all relevant information verbally. One staff member told us, “There is no printed handover. It’s hard because I don’t always know what needs to be done. We need to find a way to make sure the next person knows exactly what is happening.” People had ‘treatment escalation plans’ in place if they became unwell. However, it was not clear if staff always referred to these when people’s condition deteriorated. For example, during our visit, a staff member called an ambulance for 1 person. We asked if the person’s plan referred to hospitalisation and the staff member did not know and they had not checked the plan. This meant there was a risk that on occasion, the ambulance service might be called to review people against people’s wishes. Staff assessed people who were unwell using a nationally recognised tool, designed to improve the detection and response to any deterioration in people’s health. Care plans for people who needed support with continence provided clear information for staff, including how to monitor for signs of infection and actions to be taken to prevent this happening.

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.