Vogue Future Living Limited

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• 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

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 inadequate. At this assessment the rating has remained inadequate.

This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to consent.
 

This service scored 33 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

Some relatives told us that they were involved with care planning and reviews, however, this was not the case for most people. One person told us that they had not been involved at all, and that they had not been shown their care plans either.
We were not shown any documented reviews where the person themselves was present and involved and relatives told us that they used to be involved but weren’t anymore.

One person told us, that they remembered attending meetings before they started receiving support from the provider, but was not involved in formulating their care plans or risk assessments.
 

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.
We found that the provider was not adhering to current legislation, such as, the Mental Capacity Act (2005) and were not following guidance from external professionals, such as Speech and Language Therapists (SALT).
We found that some people who were at risk of choking, had been assessed by SALT, however, this assessment was not embedded into their care plans or day to day care. For example, one person’s SALT information stated that they do not have a need for any adaptations to their diet because they do not have difficulty with eating and drinking, however, the persons plan states that they should have a soft diet. Staff informed us they were supporting this person to eat a soft diet.
 

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.
Most staff told us, that they felt they worked together well. However, a large portion of staff told us that they felt the management team did not work well with them. Some staff told us that the management team were not approachable, and others felt there was a culture of favouritism and staff were treated differently based on some managers preferences.
The provider did not always work well with external organisations as they didn’t share information with relevant professionals when needed.
We found that the staff that worked directly with people on a day-to-day basis, interacted effectively together. We observed handover taking place at one of the services at shift change over time, and relevant, key information was shared. Staff appeared to have a good rapport with each other.
 

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.

People had Health Action Plans (HAPs) in place; however, these were generic and lacked detail. They listed some of people’s needs but didn’t reflect outcomes or desired goals.
People’s HAPs contained information that wasn’t relevant. For example, one person’s HAP stated that they no longer had a diagnosis of asthma and did not require medication for it, but the following page instructed staff to ensure they always had their inhaler on them for use in emergencies.

People’s health was not always a priority, and one relative told us that the provider prioritised people sticking to their schedules, so health appointments were often delayed if it did not fit in with what had been planned previously. They said, “[Person] attends day care all of the weekdays except Wednesdays. Staff will arrange [person’s] appointments only on that day, regardless of it is important,” and during a period that their relative was unwell, “It was 10-14 days before staff got [person] to the GP, it was confirmed with GP that [person] had a water infection.”
 

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.

People and relatives were not always involved in reviews, to discuss progress and care planning.
The provider had implemented daily note audits, where managers would spot check at random, some people’s daily notes. These were not in depth and did not contain prompts in relation to outcomes, monitoring achievements and they did not involve the person whose notes were being audited.
The provider had implemented daily recording workbooks for staff to complete, however, daily notes remained vague. For example, one entry read, “Had support with dinner,” but did not detail what support the person required, what food they had prepared and what food had been eaten.

These audits did not cover all aspects of daily records, such as behaviour logs and health appointment logs, therefore, information on these was not then embedded into people’s care plans or assessments.
 

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

Where people had the mental capacity to consent to aspects of their care provision, we were not assured they were supported to fully understand their rights and what they were consenting to.
During our assessment, we were informed by a whistleblower that managers were getting people to sign their new tenancy agreements, however, they were not taking the time to sit with people and go through the agreement, so people understood what they were signing.
The provider did not uphold the 5 key principles of the Mental Capacity Act (MCA, 2005). Some mental capacity assessments (MCAs) had been completed for some people, but these were not in line with legislation, and we found some best interest decisions had not been completed following the best interest checklist, and had been made solely by one person, from the management team.