Hebburn Court 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

We found a breach of the regulations relating to consent to care. Although people’s needs had been assessed, care plans had not been maintained to reflect their current needs. The provider was not following the Mental Capacity Act 2005 (MCA), as assessments and best interests decisions had not been carried out for people lacking capacity to consent to restrictions placed on them.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives did not comment on assessing needs. However, care plans had not recently been updated to reflect people’s current needs.

Staff said care plans were updated following suggestions and nurses explained any changes to them. Staff said they didn’t usually have time to read care plans. However, the interim management team confirmed care plans no longer reflected people’s needs and needed updating.

People’s needs had been assessed when they were admitted to Hebburn Court. The information gathered had been used to develop care plans. However, care plans had not been maintained over time to ensure they remained relevant to people’s individual needs.

Most people and relatives gave positive feedback about the quality of meals. A person with allergies commented, “The cook makes things for me so I can have treats like everyone else.” A relative said, “The food’s ok and [family member] has plenty to eat”.

The interim manager told us they had reintroduced weight loss monitoring. They had also arranged for additional education for staff about improving foods and fluids. Staff told us information about people’s dietary needs was included in their care plans. However, staff did not always fully understand what this meant for individual people. For example, where one person needed one to one support with eating, staff interpreted this as one staff member present in the dining room to supervise. Following our inspection, the provider clarified this person’s support needs with a speech and language therapist (SALT) and provided the correct care.

People’s care was not always delivered in line with best practice guidelines. People were not supported to maintain good oral health. Staff were unable to locate toothbrushes and toothpaste for people living with dementia on the first floor. Records relating to people’s nutrition did not always show they had received the correctly adapted diet. Staff sometimes recorded modified rather than specifically how meals had been adapted or in some cases did not record any adaptations at all. One person did not receive the support they needed with eating. A speech and language therapist had recommended one to one support using a teaspoon. However, this was not in place when we visited. The provider addressed this at the time. People requiring specially adapted diets, all received a pureed meal rather than what was specifically recommended for their individual needs. There were drinks stations on both floors but no drinks available. Relatives raised this in a meeting that was taking place while we were on-site.

People and relatives did not comment on teamwork.

The interim manager told us they made sure they were available for the morning handover to share information.

Following recent whistle blowing concerns about Hebburn Court, the local authority were monitoring the situation. External professionals had been assessing people’s needs and made recommendations about what was needed to ensure people were safe and their needs met.

Following the recent concerns identified at Hebburn Court, the interim management team and staff were working with a range of professionals to make the service safe and improve people’s care.

People and relatives did not specifically comment on supporting people to live healthier lives. However, some people’s wellbeing was impacted as they did not receive the care they needed.

The interim manager was arranging training days for oral healthcare and looking into the possibility of a dentist reviewing people’s oral healthcare needs. Following our visit, the provider supplied each person with toiletries and toothbrushes. They also said every person had an oral healthcare risk assessment. Staff said if they had concerns about a person’s health they would raise a concern with the nurse. A staff member said, “We know the residents well from working with them so well and recognise changes in their behaviour.”

Care plans included information about people's past medical history and health professionals involved in their care. Referrals had been made to external professionals where required.

People and relatives did not specifically comment on monitoring and improving outcomes.

Staff described how they supported people to have improved outcomes. They told us about how they supported one person to improve their mobility following an injury.

The provider’s systems to monitor people’s care and check they received good outcomes were ineffective. The interim management team told us staff did not understand the electronic care planning system, so information was not recorded accurately. Paper based records had been re-introduced as an interim measure to establish a baseline to move forwards from.

People and relatives did not provide feedback about consent.

Staff confirmed they would seek consent before providing care. One staff member commented, “I would always have a conversation with them first, I speak to them how I would like to be, so that they understand what is going on.”

People had specific care plans relating to how they gave consent. However, these often contained conflicting information. Where people lacked capacity to consent to restrictions placed on them, MCA assessments and best interests decisions had not been completed. This included decisions relating to the use of bedrails, wheelchair lap belts, covert medicines and CCTV.