Quadrant 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

Systems were in place to gather information regarding people’s health and care needs prior them being supported by the service. However, people’s care plans did not always reflect the information gathered. Risk assessments and information regarding people’s health care needs had not been put in place which would identify potential risks to people’s health and wellbeing and provide staff with the necessary information to support people safely and effectively. People were supported to access a variety of healthcare services and, on the whole, spoke positively about the care and support they received from staff and had no concerns. Systems were not in place to monitor and mitigate the risks to people. Accidents and incidents were not recorded which meant opportunities to learn lessons from these events were lost. People confirmed staff obtained their consent prior to supporting them.

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.

People and their loved ones told us they were fully involved in a pre-assessment process prior to them receiving support from the service. They told us they were confident their individual needs had been appropriately assessed and were fully understood. Despite not being involved in regular, formal reviews of their care, people and their loved ones reported they were in regular contact with the provider and any changes in care needs were shared and acknowledged.

Staff reported they were made aware of people’s care needs, directly by the provider and then through reading people’s care records. However, care files seen did not reflect some important information about people’s individual needs and risks that people had shared with us. For example, for 1 person, information regarding how to manage the risks to them had not been added to their care plan and a risk assessment had not been written that would provide staff with the information required to manage the risks to the person safely and effectively. This meant staff were not always provided with up-to-date information regarding people’s care needs.

Partners did not provide feedback in relation to assessing needs.

Pre-assessment information was not available in people’s care files and for 1 person, information regarding their particular health care needs met by another service, was not included in the care plan. Despite people telling us they were involved in reviews of their care, there was no evidence in people’s care records to demonstrate these meetings had taken place and their care records updated accordingly.

On the whole, people told us they were very happy with the help and support they received from the service and were assisted to access healthcare services as required. One relative had raised concerns directly with the provider regarding a member of staff failing to support a person in line with their agreed care needs during a mealtime. They reported the provider responded immediately to this concern, to their satisfaction.

Staff confirmed they supported people to access healthcare services as required and worked alongside other health professionals to meet people's needs. A member of staff told us, “I have a good relationship with the district nurse. If I thought there wasa problem, I would call them.” Another described how they supported a person to attend regular hospital visits.

Care plans and risk assessments were not in place to provide staff with information regarding people’s particular healthcare needs, including their nutrition and hydration needs. Although staff were knowledgeable about some aspects of people’s health and care needs, there were gaps in their knowledge due to risk assessments not being put in place. This placed people and staff at potential risk of harm. For example, information was missing in 1 person’s care records regarding a food allergy. The provider rectified this and bought this to staff’s attention as soon as they were made aware of this during the assessment.

People, their loved ones and advocates told us staff supported them to access healthcare services to meet their needs. They described support accessing GP services and attending hospital appointments. They told us staff would collect prescriptions and ensure they were present for GP appointments.

Staff reported positive working relationships with their colleagues and other healthcare professionals. The small staff group told us they would speak to a senior member of staff or the provider if they had any concerns or needed to pass information on. People were supported by a consistent group of staff who shared information with each other.

We received a mixed response from healthcare professionals involved with the service. One told us they were concerned the provider had failed to include important information in a person’s care plan or put in place a risk assessment that would provide staff with the necessary information to support the person safely and effectively and reduce known risks to them.

Staff did not have access to sufficient information required in order to deliver safe and effective care and support to people. For example, risk assessments, that would provide staff with detailed information on how to manage the risks to people, were missing from their files. A relative told us staff supported their loved one with exercises they had been advised to complete by another healthcare professional. However, there was no information in the person’s care records that would provide staff with the correct guidance on how to support the person and no risk assessment that would identify the risks to the person and how to mitigate them. This meant the person was at risk of being supported inconsistently or incorrectly by different staff.

One person described how staff supported them if they became unwell and ensure they took their medication, which had greatly benefitted them.

Staff did not have a sufficient understanding of people’s healthcare needs and the potential impact of these on their daily lives. Staff had not been provided with the most up to date information regarding people’s health care needs.

Partners did not provide feedback in relation to how the service supports people to live healthier lives.

The service did not have systems in place to ensure risks to people’s health and wellbeing were consistently identified, assessed, managed and communicated to staff. People’s care records did not hold person centred information regarding their health care needs. For example, when 1 person moved to this service, information held on file from a healthcare professional providing advice and guidance on how to support the person if they became unwell, had not been included in their care plan and a risk assessment was not in place to mitigate against the risks associated with this condition. The provider had failed to ensure staff were provided with informationthat would reduce the risk of harm to the person and to themselves and ensure continuity of care.

On the whole, people, their loved ones and advocates were happy with the care they received and felt they were supported by a group of staff who knew them well. One person told us staff knew them well and were supporting them with their medication. They described the positive difference this had made to their lives.

Staff were aware of people’s day-to-day care and support needs, and the general support they needed to maintain good health. However, staff were not sufficiently aware of people’s individual risks and the implications these had for their care. Staff confirmed they shared information with people’s relatives and advocates and worked alongside other professionals.

Risks to people had not always been explored and staff were not provided with the information to monitor and mitigate those risks to assess whether people were being supported safely and in line with their care needs. Despite staff telling us they would report any accidents or incidents, there were no records of these events. The provider failed to ensure people’s care and treatment was routinely monitored and opportunities were lost to learn lessons or look for any potential trends, placing people at potential risk of harm.

People, their loved ones and advocates confirmed staff obtained their consent before offering support to them. An advocate told us the provider would visit their loved one regularly, particularly if any concerns had been raised, in order to ensure their wishes and views were taken into account regarding the delivery of their care.

Staff understood the need to obtained people’s consent prior to offering support. A member of staff described how they would do this with an individual. They told us, “[Person] has capacity and I would use medication as an example. I would go to them first and see if they were ok to have their medication and if so, I would prepare it for them.”

Despite people telling us they had been involved in planning their care, there was a lack of evidence in people’s care files to demonstrate this.