Compassion Care 24/7 Supported Living Limited

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.

This is the first inspection for this service. This key question has been rated 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. Assessments were usually completed in person by an office staff member and included information from referrals, people and their families. Staff confirmed assessments helped them understand people’s needs, with one saying, “The managers do the assessments, we tell them of any changes and they update them.” However, assessments and care plan reviews were not always completed within required timescales, and some needs were not fully captured. For example, care plans lacked detail about some medical conditions meaning there was a risk staff would not have the information to safely meet these. One person told us staff were helpful contacting the GP, but documentation did not consistently reflect how their health needs should be monitored or escalated. These gaps reduced assurance that assessments consistently supported safe, effective care.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Evidence‑based tools to assess nutrition and skin integrity were not used consistently. A staff member said, “I am not sure what MUST [nutrition assessment tool] is,” indicating gaps in understanding. Care plans did not include adequate clinical information about people’s conditions. In one case, a person’s records referenced a bowel disorder as Crohn’s disease, but there was no confirmed diagnosis. Care plans for nutrition and hydration lacked detail for people fully dependent on staff to provide all their food and drinks. Monitoring charts for bowel care and skin integrity were incomplete or missing. Although staff adapted care well in practice, the provider did not ensure evidence‑based frameworks were embedded across the service.

The provider 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. People and families also described effective joined‑up working, including prompt GP contact, hospital support and coordination after emergencies. There were no concerns about communication barriers with external professionals. While documentation did not always demonstrate oversight, feedback from staff and people showed day‑to‑day teamwork was effective. Staff worked well together and were positive about communication systems. They described regular updates through the providers care app, group chats and phone calls. One staff member said, “We always communicate,” while another explained they could “call the manager or senior carer to confirm any changes.”

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 told us staff supported them with healthier routines, like walks or meal preparation. However, care plans lacked essential information about health conditions and monitoring needs. For example, bowel monitoring was not in place for a person prescribed a laxative, and there was no clear guidance for a person with a specific health need. One person said, “I want to go for a walk, it’s in my care plan,” but this had not always been followed. While staff promoted healthier choices in practice, documentation and clinical oversight were inconsistent.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. The service monitored people informally through regular contact and staff feedback. Care staff described how they reported changes, and relatives told us staff were proactive, with one saying, “They will let me know if she is running out of medication.” Office staff also carried out some care calls, which allowed ongoing checks. However, formal reviews were overdue, and incomplete care plans meant important outcomes, such as nutrition, hydration, skin care and bowel health, were not always monitored. While staff responded to emerging needs, systems did not ensure oversight or measure whether support consistently improved outcomes.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. The provider did not have effective Mental Capacity Act (MCA) systems. Managers lacked a full understanding of mental capacity and their roles in respect of this. The service had not completed any mental capacity assessments meaning care plans did not include decision‑specific capacity assessments for people who lacked capacity. We were told external professionals had completed capacity assessments. The service had a copy of this for a person but not for another person they told us had been completed. One person receiving 24‑hour support could not consent to this arrangement, but no community Deprivation of Liberties [DoLS] application had been made.

Staff respected people’s choices, telling us, “If they say no to a shower, we try later and record it,” but this was not supported by legal processes. While people said staff respected their privacy and preferences, the absence of MCA documentation and unclear DoLS processes meant legal requirements were not met. The management team undertook to ensure mental capacity assessments were undertaken.