Archived: Eboracum 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 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 they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Some staff told us that people’s preferences and needs were ascertained by speaking to people and through the provider’s internal processes, such as, handover records. Some staff were able to tell us detailed information about the people they support. However, other staff had difficulty in identifying safety issues in relation to people's needs at lunch time when asked by inspectors.

People's care plans were not always up to date. Inconsistent information was viewed which related to the monitoring of people’s health and care needs. Some care plans and risk assessments lacked sufficient detail to ensure appropriate care was delivered.

Governance and audit process at the service had failed to identify deficiencies within people’s care plans and risk assessments.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.People told us staff supported them as needed with the provision of meals, snacks and drinks throughout the day to ensure their dietary needs were met. We observed the lunchtime meal we saw people were not offered any choice. There was no menu board displayed.

A minimal number of activities were available to people. Further work was required to ensure activities were available more often and more person-centred and meaningful to people. People were seen to spend large amounts of time unoccupied, with televisions playing without people actively watching them or engaged in any other types of pastimes.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Processes in place at the service had failed to ensure that information recorded about people was always up to date, accurate or sufficiently detailed. This meant when information was shared about people between services, the quality of this information could not be guaranteed.

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.

We received mixed feedback from people and relatives about the quality of care provided. Our findings showed some people had not received the support they required to enable them to live healthier lives. Staff had completed an assessment of people’s risks to their health and wellbeing and on how to support people to prevent deterioration. However, we were not fully assured staff would recognise and report people’s deterioration. Records did not always reflect actions taken by staff. For example, where people had been refusing to take their medicines, there was no record of action taken by staff.

The service had not promoted people’s wellbeing by providing meaningful activities. One person said, “I’m bored, there ought to be some activities.”

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

Some people’s care was not routinely monitored to ensure they received the care and treatment they needed. For example, staff did not monitor people’s fluid intake or track changes in people’s health to promptly identify issues of concern. This meant there was a risk people may not receive consistently good outcomes.

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

People's care records did not contain clear and up to date information about their needs or choices. It was not clear when people did not have the capacity to make decisions.

There was not always a record of signed consent or best interest meetings taking place when significant decisions needed to be made. For example, where there was a need for potentially restrictive interventions, such as bed rails.

Care staff understood the need to give people choices; however, we didn't always see this in practice. For example, people were not given a choice of hot or cold drinks at lunchtime, although they appeared satisfied with what they were served.

The systems and processes in place to ensure people were supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing required improvement.