Highwood Mill Extra Care Scheme

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 58 (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.

People’s needs were not comprehensively assessed and did not always include consideration of all of their needs. This meant staff did not have all of the necessary information to enable them to support people effectively.

For example, the provider had assessed a person’s needs, but they had not explored the risks sufficiently to ensure these were fully understood and staff had clear direction as to how to manage these risks, and what they must do if something went wrong. This meant that people were at risk of not being supported safely.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Nationally recognised tools were not used to help inform care planning and outcomes for people. Where people had already been identified as being at increased risk of skin breakdown, Waterlow scores (a calculation which helps care providers estimate the risk of a person experiencing a pressure sore) had not been completed. MUST (a tool to help care provider’s identify people at risk of malnutrition or obesity) had not been completed, which potentially meant staff could not effectively understand people’s specific needs to enable them to deliver the best possible care.

Although nationally recognised tools were not being used, when we spoke to staff, they did know how to recognise and raise concerns in relation to weight and skin issues.

The provider worked well across teams and services to support people. Communication between staff and leaders had been an issue but this had improved through the introduction of shift leads and structured handovers, reducing confusion and ensuring continuity. External partners, including housing providers and local authority teams, were engaged in multidisciplinary meetings to review complex cases and agree changes to care packages.

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 maintain independence, wellbeing and community involvement. Staff encouraged independence and adapted care to meet individual goals. One person told us: “I said I wanted to do things for myself, and the carer sat with me and found a way. Over months, I improved and started walking again.”

When things went wrong or needed maintaining, referrals were made to the housing provider to ensure people’s access to adapted kitchens and equipment continued to promote independence. Staff facilitated wellbeing calls, minibus outings, and on-site activities such as choir and bell-ringing sessions.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. This meant that outcomes were not always positive and consistent, and met both clinical expectations and the expectations of people themselves.

There was a lack of effective monitoring of people’s needs by the provider to ensure people were safe and received effective care and support. The provider and registered manager were not fully aware of the key needs and risks people faced which made it difficult for the registered manager to monitor these.

Incidents were not always effectively reviewed to check the outcomes were appropriate and if actions were needed to improve the care individuals received.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, the provider had failed to ensure that people had not always signed their care plans to indicate overall consent. Sometimes a family member had signed the care plan without a clear explanation as to why the person themselves had not signed to indicate their consent. Some people told us they were aware of their care plan and a copy was kept in their property.

Staff always sought consent from people before carrying out any task and this was clearly recorded. One person told us, “Staff always ask for permission before providing care.”