Progressive Support Services Ltd

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 is requires improvement.

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

The service was in breach of legal regulation in relation to consent.

This service scored 50 (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 did not always make sure people’s care and treatment were effective because, while they discussed people’s needs with relatives, this did not always result in people’s care plans, risk assessments and daily care records containing clear and adequate information.

Care plans did not always contain relevant information about people’s health, care or wellbeing needs to support staff in providing safe and effective care. For example, where people had identified health and mobility needs, they did not always have a care plan or assessment which provided guidance to staff on how they could support people to meet these needs. This meant people were at risk of their needs not being clearly known and delivered by staff.

Risk assessments and some care plans were not reviewed on a regular basis.

Most people and relatives told us they were not involved in people’s care planning, with 1 relative telling us, “We haven’t had a care plan review – it's been over a year now.” The provider stated people and relatives were involved in people’s care planning in the earlystages of people receiving care from the service, but acknowledged this could be better on an ongoing basis.

The provider did not always plan and deliver people’s care and treatment, in a way which was important to them.

Evidence-based assessment tools were not always in place to identify risks to people’s health needs. For example, best practice assessment tools had not been used for people with skin integrity needs. This meant care plans did not always provide detailed, evidence-based information, which meant people were at risk of their needs not being identified, planned and managed by staff in line with evidence-based approaches.

Staff we spoke with demonstrated an understanding of people’s preferences, including how they asked for food and drinks.

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

Care plans and risk assessments were not reviewed and updated with new information and guidance to staff on people’s needs and risks following accidents and incidents, including those where people had been exposed to risk and harm. Staff meetings did not take place on a regular basis. This meant opportunities for the provider to provide internal understanding and awareness of key issues were missed.

The provider worked in consultation with some external services, such as healthcare professionals, local authorities and CQC.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control.

People’s care records did not always contain relevant information needed to ensure people could be supported to positively manage their health and wellbeing. Information relating to people’s health conditions and needs did not always contain the guidance staff needed so they could support people to live healthy lives. For example, people living with health conditions which affected how they were able to mobilise, did not have a care plan in place which referred to how these conditions affected their mobility and, therefore, provide guidance to staff in this area of their care. This meant people were at risk of their health needs not always being met.

Staff had not received training relevant to some people’s health needs, and some staff did not have an awareness of the health conditions people had nor how these affected them. However, staff demonstrated an awareness of the practical support they provided people based on some aspects of their health needs. For example, staff told us how they supportedpeople with their mobility needs which mitigated risks associated with this. This was supported by the feedback we received from most people and relatives.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent.

People’s care records were not effectively monitored and reviewed by the provider. With an absence of care plan audits, the provider was unaware of some of the specific concerns we identified regarding the lack of relevant information in people’s care records and people’s care and health outcomes. This meant there was a risk the care and treatment people received from staff may not always meet their needs.

Most people and relatives told us there was limited contact with the provider once people had started receiving care from them. The provider acknowledged this was an area they needed to improve. Records showed people’s care was monitored by the provider obtaining occasional people and relative’s feedback via satisfaction surveys.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. The service did not always consider the Mental Capacity Act 2005 (MCA) when supporting people. Decision-specific mental capacity assessments and best interest decisions were not in place for people identified as lacking mental capacity regarding their care arrangements. This meant people were at risk of their rights under the MCA not being respected.

Staff training records showed staff received MCA training and staff we spoke with demonstrated an awareness of the need to seek consent from people. However, the feedback we received from people and relatives in this area was mixed: with some telling us consent was sought from people, while others saying it was not.