Mount Pleasant 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 requires improvement. At this assessment the rating has remained 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 were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The acting manager regularly reviewed people’s care needs. However, there was limited evidence that people using the service, or their relatives, were involved in these reviews. The provider used a digital care planning system, and while the ‘review’ section was completed monthly, it did not record who had been involved in the review process. Relatives told us they had not been shown or involved in reviewing people’s care plans.

People told us they were kept informed of any changes to their care and said that, when required, healthcare professionals such as district nurses or doctors attended promptly.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider used a digital care planning system to record people’s histories, assessed care needs, risk assessments, and reviews. However, several care plans lacked sufficient detail to guide staff effectively.

Records showed 1 person had regularly refused to eat. Their nutritional care plan stated only their preferred foods and that the person was able to ‘feed themselves’. There was no guidance to inform staff how to support the person if they refused to eat or what level of assistance was required.

Behaviour care plans were not available to support people during times of distress. A member of staff told us that due to another person shouting, one person “won’t come down… he doesn’t like it.” There was a risk the person may become isolated due to a lack of planned support or guidance for staff on the actions they should take to reduce this.

We reviewed daily records for 2 people and identified occasions where people had refused personal care, such as washing or changing their clothes. When people declined personal care, care plans did not provide staff with guidance on how to respond or support the person appropriately. This meant people were at risk of harm, as their personal hygiene needs were not consistently addressed or recorded.

We found 1 person’s care plan identified their weight should be recorded at least every 31 days. However, this had not been completed for 48 days. The acting manager told us this was due to the weighing scales being broken but the scales had recently been repaired.

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.

Two people had recently been admitted to the service, 1 from hospital and 1 from the provider’s sister care home. The acting manager told us they had not received pre-admission information to inform staff of people’s medical histories or care needs. There was no further information to confirm their care needs could be met prior to admission. Following the assessment the acting manager provided evidence of notes taken during a phone call prior to one person moving into the service.

For 1 person, the ‘About Me’ section of the care plan had not been completed. This meant staff did not have access to important information about the person’s background, preferences, or life history, limiting their ability to provide person-centred care.

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.

Care records demonstrated a range of healthcare professionals were involved in people’s care and treatment. Staff made appropriate and timely referrals to support people to maintain good health. Healthcare professionals confirmed staff worked closely with them to ensure people’s health and medical needs were met.

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 andconsistent, or that they met both clinical expectations and the expectations of people themselves.

Incidents had not always been effectively reviewed to confirm if actions were needed to improve the care individuals received. A complaints log and incident log did not consistently reflect what, if any, actions had been taken to mitigate risk and improve people’s outcomes.

People’s records did not consistently demonstrate how their health was monitored. Following the repair of weighing scales, there was a delay in re‑commencing weight monitoring. This meant potential changes in people’s health were not identified nor acted upon in a timely way.

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

One person’s consent form confirmed they were ‘happy for a carer to assist [them] with taking [their] medication’. The acting manager told us this person refused to have certain staff assist them with medication. Whilst this was respected by the staff, the records had not been completed in full, and staff were not directed on what actions to take if the person declined.

During the inspection we observed staff ask what people would like to drink and where they would like to sit.