Nevin 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 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 54 (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 was effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People’s support plans were developed from an assessment of their needs completed prior to them moving to the service. However, they did not always have robust details and information for staff about specific needs. For example, there was no guidance for staff to support a person who had diabetes should this become unstable. While some staff knew how to support this person, other staff were not aware the person had diabetes. People’s care and support plans were not always updated following a change of need. For example, a person’s support plan was outdated despite being reviewed a few weeks prior to this inspection. Part of their care plan included an activity they no longer participated in.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Staff were not aware of best practice guidance in relation to supporting people with a learning disability and autistic people. For example, a staff member described a person inappropriately stating, “He does some things autistics do.” Another stating staff member stated, “I don’t really know much about learning disability”. People’s nutrition and hydration needs were met and their care plans had details for staff to follow with regards to people’s dietary needs.

The provider worked across teams and services to support people. The provider had formed links with the GP, chiropodist and other specialist healthcare professionals. Staff told us how they shared information about people through handovers to ensure any changes in need were known and escalated when required. For example, staff told us a person who can’t communicate verbally had a picture board to support the person to understand what is happening each day. Staff told us they worked well as a team and if any additional support was required, staff would take the appropriate action to seek any additional support.

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. People were supported to attend regular health checks and receive ongoing care from healthcare professionals such as dentists, opticians and chiropodists. Staff worked with people’s relatives to enable people to engage with health monitoring and routine testing. One relative told us, “This team look at his medical side, they’ve made an effort, they go to the doctors, know how he is, and have conversation with him.” Referrals had been made to healthcare professionals such as speech and language therapist where people experienced communication and/or eating and drinking difficulties.

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. Whilst staff provided the support people needed, a lack of consistent and accurate recording meant it was difficult for the provider to monitor and explore reasons for changes in their behaviour. Relatives told us providers sought their opinions by sending out surveys and via telephone calls. However, there was no evidence to show that people’s views about what they wanted to achieve in their life had been sought using their preferred communication methods.

The provider did not tell people about their rights around consent or respect these rights when delivering care and treatment. The provider had not ensured staff had completed training in the Mental Capacity Act 2005. Staff demonstrated understanding and were able to talk us through scenarios and how they would seek consent when supporting people. However, care plans instructed people to be told rather than asked. For example, one person’s care plan stated staff should tell them when it is time for them to rest. This took away the person’s opportunity to make their own decisions. People had mental capacity assessments in place.