Letheringsett Hall

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 has changed to 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 58 (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. We found plans in place for 1 person to be contradictory. For example, we reviewed a falls risk assessment for this person which stated that the person had no history of falls. However, we reviewed a log of recent falls for the person. Therefore, this plan did not give a clear and up to date information of the persons current needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standard. People received a choice of meals and drinks. People were positive about the meals. One person said “The food is nice and you always get something that tastes nice. You can choose what to eat and I am always full. They make sure you have a drink as well.” One relative told us, “The food always smells nice. It looks home cooked and looks good. There is always variation of food. If [family member] needs anything they will get it. There are always fluids available.”

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. Staff worked well with other health care professionals to support people. The service had a log of the details when health care professionals had visited. However, the service did not consistently make referrals to relevant professionals when people’s needs changed. We identified 1 person who had recently altered their sleeping arrangements, but the provider had not made a referral to an occupational therapist to assess the new setup. This meant there had been no professional evaluation to ensure the person remained safe and comfortable.

However, 1 relative told us “They deal with the GP, Optician and District Nurse and they then let me know what happened. [family member] did end up in hospital recently and they kept me updated the whole way through. I was very happy with how they handled it.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Records showed people were supported to attend health appointments. During our site visit, we observed the Registered Manager supporting a resident to a health appointment.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Staff knew people well and understood their needs. Documents were completed to monitor people’s health needs and changes. One healthcare professional told us, “I think the Hall is run very well, patients and staff are happy, they all know me and I know them very well too. They are reactive to needs of the patients. The patients all seem to be well cared for and happy.”

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 provider did not always work within the principles of The Mental Capacity Act 2005. There were some capacity assessments in place for people when needed, however, these did not always consider all the relevant aspects of people’s care. For example, one person had a Deprivation of Liberty Safeguards (DoLS) applied for, however there were no mental capacity assessments completed with the person to assess this need. Another person had consent forms in place that were signed by a family member. However, the registered manager informed us the person had capacity, there was no evidence that the person had consented to their relative signing these forms on their behalf. We received feedback from people regarding staff gaining consent before carrying out care duties. One person said, “not really they just walk in, and we get on with what they need to do.” Another person said, “They have asked for consent sometimes but really, we just get on with things. I know what they are going to do so it is fine.” We raised these concerns with the service at the time of the inspection. The registered manager informed us that they would be reviewing their current ways of working and implementing mental capacity assessments promptly.