Chiltern Support and Housing

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 71 (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. Care records included information relating to health, care, wellness and communication to enable care and support to be delivered.

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. Care records included guidance for staff to follow such as, following the positive behaviour support plan and for the staff to use their Non-Abusive Psychological and Physical Intervention (NAPPI) training at the right level. The service had recently communicated with professionals to request information to support, “accurate care planning and shared understanding.”

The provider worked well across teams and services to support people. The registered managers told us they held multi-disciplinary meetings, worked with professionals and the safeguarding 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. Care records included information regarding daily routines, communication, responding to distress, personal care and sleeping patterns. Care records included information regarding GP services being accessed.

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. The provider had systems in place for monitoring the care provided as they regularly met with relatives. Daily notes were recorded of what support was provided to people.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Staff were guided to communicate with people about their choices using sounds and gestures. This enabled people who didn’t use verbal communication to communicate with staff. However, we were not assured the provider understood their responsibility in relation to obtaining consent and conducting mental capacity assessments. The Mental Capacity Act 2005 says “A person must be assumed to have capacity unless it is established that he lacks capacity” and, “For the purposes of this Act, a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain.” Care records stated a person had capacity to make simple day to day decisions but “cannot make complex decisions” and they, “cannot make decisions about [their] medication.” It was unclear what the “complex decisions” were. The care records included various signed “Consent” documents such as, “Consent for Personal Care” which were signed by a representative. Mental capacity assessments had not been actioned for all these “Consent” documents nor the “complex decisions”. Whilst we identified a mental capacity assessment had been completed for medicines, other decision specific mental capacity assessments and best interest decisions had not been completed. The registered managers told us staff asked for consent and this was recorded in the daily notes. However, the daily care notes did not always show staff obtained consent before carrying out personal care. However, the provider informed us they worked with professionals regarding community Deprivation of liberty safeguards (DoLs).