HF Trust - Lympne Place (High Trees and The Beeches)

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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s health, social and emotional needs were assessed before they moved to the service. People were invited to visit the service and meet staff before deciding if they wanted to make the service their home. Assessments were used to develop the person’s care plan. Care plans contained detailed guidance about specific health care needs such as how to recognise and support people who had epilepsy or too much or too little sugar in their body due to diabetes.

People had a one-page profile which set out the most important information staff needed to know about them to be able to support them in the right way. Some people had individual ways of communicating their needs and wants. Communication passports had been developed which guided staff about how people with limited or no verbal communication may present when they were happy, sad or in pain.

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 standards.

The provider used positive behaviour support (PBS) which is a recognised proactive support framework for people who find it difficult to communicate their anxieties. Staff had received training in supporting people to manage their anxieties and promote a positive and safe environment for everyone involved.

People’s needs around their eating and drinking had been assessed and guidance sought from health care professionals. Staff and people ate together at lunchtime and we observed staff supporting people to eat according to this guidance.

The service did not always have a proactive and positive culture of safety.

There were significant omissions in daily records relating to people’s health and safety. The provider told us there were issues with the internet which meant that staff were not always able to access records in a timely manner. The provider had implemented checks on these records and some were being completed on paper, but this was not consistent. Without consistent or complete information, the service could not effectively identify, monitor and act when required.

Lessons learned were discussed at team meetings and as a result changes had been made to make improvements. However, lessons learnt about best practice in manging potential risks and staff practice with regards to safeguarding had not been implemented consistently. Guidance in minimising the risk of people being constipated and safeguarding procedures had not always been followed.

People with anxieties which they may present verbally or physically had positive behavioural support plans (PBS). PBS isa person-centred approach to understanding and managing challenging behaviours, focusing on preventing them and improving quality of life. These plans were developed and monitored by the provider’s national PBS team. However, the team had significantly reduced in numbers so they were not able to provide the necessary level of support to staff and people. PBS plans had not been reviewed yearly as planned which meant it could not be assured guidance for staff was the most up to date and effective. The provider told us there were plans to train a staff member locally to provide this support going forwards.

There was inconsistency in how the provider supported people to manage their health and wellbeing or support people to live healthier lives.

Although relatives told us people were supported to attend regular health care appointments to manage their health, these had not always been recorded.. The provider took action to address this after it had been brought to their attention.

There were differences in staff skills and competency in when people had become unwell. This was confirmed by feedback from external professionals who told us, “I have no doubt certain members of staff are highly efficient, however, if they are not on shift, I would question those that were”. Staff knew people well but had not felt competent to seek medical advice when a person’s health had deteriorated. Staff had taken time to contact the registered manager which may have delayed them getting the support they needed. When another person had become unwell important information about their deterioration and treatment had not been recorded. Therefore, it was not easy to establish if person’s health had effectively been managed and medical assistance sought in a timely manner.

The service did not always have a proactive and positive culture of safety.

There were significant omissions in daily records relating to people’s health and safety. The provider told us there were issues with the internet which meant that staff were not always able to access records in a timely manner. The provider had implemented checks on these records and some were being completed on paper, but this was not consistent. Without consistent or complete information, the service could not effectively identify, monitor and act when required.

Lessons learned were discussed at team meetings and as a result changes had been made to make improvements. However, lessons learnt about best practice in manging potential risks and staff practice with regards to safeguarding had not been implemented consistently. Guidance in minimising the risk of people being constipated and safeguarding procedures had not always been followed.

People with anxieties which they may present verbally or physically had positive behavioural support plans (PBS). PBS isa person-centred approach to understanding and managing challenging behaviours, focusing on preventing them and improving quality of life. These plans were developed and monitored by the provider’s national PBS team. However, the team had significantly reduced in numbers so they were not able to provide the necessary level of support to staff and people. PBS plans had not been reviewed yearly as planned which meant it could not be assured guidance for staff was the most up to date and effective. The provider told us there were plans to train a staff member locally to provide this support going forwards.

Staff understood the importance of gaining people’s consent and capacity assessments followed the principles of the Mental Capacity Act 2005 (MCA).

Assessments included specific decisions about whether people could understand, retain and weigh up the information and communicate their decision. Where people had been assessed as lacking the capacity to make a specific decision, best interest meetings had been held with interested parties.

Staff had been trained and followed the principles of the MCA in respecting people’s choice to make decisions whilst giving them relevant information and encouragement so they could make a fully informed decision. We observed that staff gained people’s consent before offering any support or assistance.