Archived: Schoen Clinic York, Wellen 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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had missed opportunities to maximise the effectiveness of people’s care and treatment by continually reviewing people’s health and care needs.

Staff had completed preadmission documentation, and care plans were in place. However, care plans were not dated, and there was no evidence staff had reviewed these on a regular basis, or when people’s needs changed. Records relating to people’s needs was not accurately recorded to ensure staff could support them appropriately.

People were not being weighed in line with their care plan, which meant they were at risk of not receiving additional support if there were changes in their condition or weight.

The provider did not always deliver care in line with current legislation and evidence-based good practice and standards.

People who displayed distressed behaviours had been referred for professional support. However, care plans were not detailed on what measures staff should use to support them prior to administering medicines. For example, by using distraction or de-escalation techniques first.

The provider was not effectively monitoring outcomes for people’s health conditions. For example, where follow up action was required, the outcomes or action taken was not always recorded.

The provider did not always work well across teams and services to support people.

It was recorded in one person’s care plan that they would require a referral to the falls team following several recent falls. However, there was no evidence this had been completed. Nor a clear rationale as to why staff had not made the referral when it was identified.

There was a weekly visit from a nurse practitioner, which was overseen by the GP. We received mixed feedback from health professionals who worked with the service. Comments included: “The service has got better at listening and following advice” and “Previously raised concern – no improvements since last visit - 2 weeks ago.”

The provider did not always support people to manage their health and wellbeing to maximise their independence, choice and control. Staff did not always support people to live healthier lives.

People were not encouraged and supported to understand and make healthier choices, including their diet. People were not always provided healthy options at mealtimes, and the choices were limited.

There were concerns that people were losing weight. One family member explained their relative had a ‘referral to dietician and was required for them to have milkshakes but that has not been done.’

Similar food options were served on 2 consecutive days which were of limited nutritional value.

There was a lack of recording and monitoring of people health records to ensure they were visiting different health professionals such as dentists, opticians or podiatrists.

Staff did not always have good knowledge of relevant health care concerns for people. For example, staff could not identify if a person required a specialist diet. Staff also did not have specific training to support health concerns such as diabetes.

The provider did not always routinely monitor people’s care and treatment to improve people’s outcomes. Clinical monitoring tools were used but they were not always completed fully or replicated in the persons care plan.

People’s health and wellbeing was not being consistently monitored by staff. We identified inconsistencies in relation to the monitoring of bowel movements, blood monitoring and positive behaviour support. We could not always be assured appropriate action had been taken in these areas due to the inconsistencies in staff recording.For example, a positive behaviour support plan was in place, but it lacked detail. One entry stated, ‘Engage person A in conversations of things that may be of interest and that do not cause any distress’ but there was no further information about what this meant.

Staff did not have clear guidance to direct them to administered medicines. For example, there was no protocols in place for ‘as and when required’ medicines.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood and respected people’s rights and decisions regarding consent. Staff sought people’s consent before providing care and they respected people’s choices. People responded well to staff who approached them in a considerate manner.

The provider had assessed people’s capacity to consent and had recorded this information. Where people lacked capacity records were in place to show how staff acted in people’s best interest.