Mulberry House

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.

This service scored 42 (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 failed to identify that people's care plans and care records did not always evidence people’s health, care and preference needs being met.

At our last inspection we found people’s needs were not always fully assessed. During this inspection we found not enough improvement had been made and we continued to find concerns in this area.

For example, in relation to mobility aids, or ongoing medical appointments and progress. We received mixed feedback from relatives regarding care plans. In relation to having been involved in or receiving a copy of their relative’s care plan, one relative said, “Occasionally (I am involved), not had one officially in a while though.” Another relative said, “I have in the past, not lately.” This lack of information meant that the provider could not be certain they had all the relevant details about each person and their care needs to ensure the delivery of safe care.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Care plans were not up to date, there was limited evidence people had been involved in planning their care. The provider did not have regard to ‘right support, right care, right culture guidance’, as evidenced throughout this report. People did not always receive safe care and support, the environment was not always clean or safe, people were not always supported to pursue their hobbies and interests, care was not always person centred, and peoples’ goals and activities were not always well documented.

The provider did not always work effectively across teams and services to support people. Whilst there was evidence of engagement with other professionals, such as the GP, we found that records did not always reflect the current needs of people using the service. For example, one person’s care plan stated they could mobilise with minimal support, however they were no longer able to do so and required significant amount of support from staff following an injury they sustained 4 months prior. Care plans stated staff should work with and follow instructions from health professionals to manage this need, however there was no further information to state what this support was. As a result, there was a risk that professionals involved in people’s care would not have access to up-to-date information.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Care plans were outdated or did not contain information about how to support people to maximise their independence. For example, where people had lost skills or confidence during the COVID-19 pandemic, or following injury, the provider had not clear plans in place to support people to rebuild their skills of confidence to enable them to go back to doing the things that were important to them.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

For example, where people had ongoing health conditions, care plans contained limited information about how to support people with these and what measures were in place to alleviate or improve people conditions. This meant staff were unclear on what they should do to support people with their health. We identified an incident where staff did not act appropriately following a deterioration in one person’s health condition.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Mental Capacity assessments were completed in areas such as care, finances and medicines. Deprivation of liberty applications were made where appropriate, however, where restrictions were in place such as the kitchen, laundry and freezers, there was no evidence this had been discussed with people living in the service.