Archived: Sitara Haven

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 requires improvement. At this assessment the rating has remained 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 to care and treatment.

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 service did not always make sure people’s care and treatment were effective. While the provider stated that people were involved in the planning and review of their care, there was little written evidence that this happened in a meaningful way. Care records showed a lack of involvement from people and relatives in the assessments and review of people’s health and care needs which was mainly completed by staff. Therefore, we could not always be assured that positive outcomes were achieved for people’s care, treatment and support in accordance with their specific needs, preferences and requirements.

People’s communication needs were not always outlined within their care plans to enable them to receive care and treatment which worked for them. There was a lack of evidence that staff reviewed people’s needs to identify if there had been any changes so they could take appropriate action to meet their changing needs.

The provider did not consistently plan or deliver care and treatment in accordance with legislation, recognised standards, and evidence-based guidance.

Care plans lacked sufficient detail to reflect people’s specific needs. Staff had not received training aligned with best practice to support people with mental health needs and a learning disability, and their behavioural needs. This posed a risk to continuity of care, as care documentation did not always reflect current support needs.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. The provider worked with other health and care teams and services to support people. They shared information about people’s needs when people moved between different services. The provider communicated and shared information about people’s needs with other teams and their own internal staff team. For example, there were team meetings. Where people’s needs had changed the provider told us they contacted health and social car professionals to review the persons needs and conditions to help ensure their wellbeing.

The service supported people to manage their health and wellbeing. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were referred to health professionals, and the provider had a visiting community nurse to monitor a person who required daily blood pressure checks over a period of time.

Care records showed input from health and social care professionals including Gp, dental and community nursing team.

Whilst the provider monitored people’s care and treatment to help improve it, they focused on short term goals and have not always considered people’s longer term goals, ambitions and their expectations so they achieved improved outcomes.

There was little information in people’s care records about people’s longer term goals, ambitions and aspirations and how the provider was supporting them with these. People’s care was also not monitored in a comprehensive way, such as when they expressed anger or anxiety to identify trends and patterns and the most appropriate way to support them. This meant we could not be assured people’s health and wellbeing outcomes were being adequately monitored and addressed.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

The service did not consistently work in accordance with the requirements of the Mental Capacity Act 2005 (MCA) and associated code of practice. The provider’s lack of knowledge and understanding of MCA and what it means in practice meant people’s rights could not always be upheld.

Where a person was deemed to lack capacity, there was a lack of evidence to show the service acted in accordance with the MCA and the correct process was followed to ensure decisions were made in people’s best interests. For example, for one person, forms were completed by staff around consent to personal care with references made such as ‘discussed with person.’ However, there was no information showing what had been discussed and agreed with family representatives, therefore we could not be assured that decisions were appropriately made in the person’s best interests.

We observed people were not always asked for their consent, choices and preferences. We saw the TV being switched on without asking the person if they wanted it on or what programme they wanted to watch. Their room was being used for other purposes without their recorded consent or evidence that a best interest decision had been made

Whilst staff received training, this was not effective in ensuring consent to care and treatment processes were upheld.