Collaborative Care Services Ltd

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 assessment for this registered 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.

There was a breach of regulation in relation to capacity and consent.

This service scored 62 (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 needs were thoroughly assessed, and information was transferred to people’s care and support plans. The manager explained the process for new people moving to the service. They told us, “We visit them at their current placement, put an assessment form in place, which covers areas like personal care, medicines and independence. We then convene as a team to discuss. We also request documents from previous placements, like previous care plans and incident reports. We then create our own care plan from all this.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, they did not always do this in line with legislation and current evidence-based good practice and standards. For example, the service did not always understand or apply the principles of the Right Support, Right Care, Right Culture guidance.

However, care records contained details of people’s needs and preferences and how to support them. Staff communicated well with people and there was a clear relationship between the people living at the service and the staff supporting them. Staff knew people’s needs and preferences. People were relaxed within their home and were involved in decisions about their care.

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. The service regularly liaised with other healthcare professionals, such as the mental health team, social workers, and the GP. A relative told us, “The service works very well with other teams, because if there are any changes with [person’s] health, they notice the changes and inform everybody and me, and a plan of action gets put together with [healthcare professional].”

Staff described working relationships with healthcare professionals and external partners as “strong and effective.” One staff member said, “The service maintains regular contact with healthcare professionals, social workers, families, and other relevant agencies to ensure that everyone involved in an individual’s care is informed and working towards common goals. There are no barriers.” Staff told us they worked well together as a team.

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. Staff supported people to create meal plans which followed a healthy, balanced diet. People were supported to attend activities which involved physical activity. Staff raised any healthcare concerns with relevant healthcare professionals.

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. People’s care was regularly reviewed. Where health concerns were identified, these were escalated appropriately. People had documented goals which were regularly reviewed, to improve outcomes for people. Staff told us this helped them support people’s quality of life.

The provider did not respect people’s rights when delivering care and treatment. People’s consent was not always obtained where appropriate. For example, during a site visit to a person’s house, staff offered to show inspectors around, without first obtaining the person’s consent.

Additionally, the service did not always act in line with the Mental Capacity Act 2005. Mental capacity assessments (MCA) and best interest (BI) decisions were not always in place where appropriate. For example, there was no MCA or BI decision for the management of a person’s medicines. We were also told that a person had been advised by a healthcare professional to limit the intake of a particular drink, but found there was no associated MCA and BI decision for this. This meant the person’s human rights were not upheld. Additionally, we found a person’s tenancy agreement had been signed by an unauthorised person, which meant the tenancy agreement was not valid. We raised this with leaders who told us the actions they would take to address the concerns.

However, staff had received training in the MCA and were able to talk about the key parts of the legislation. People had MCA and BI decisions in place for other aspects of their care and support