Harvey Lane

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.

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.

Support plans were in place for people; however, they were of mixed quality and quantity. One person’s support plan which was viewed was in depth but included some inconsistencies, while another person’s lacked information. For example, it did not include all their known risks and behaviours, and some sections directed staff to another section for information, however, that section did not include the information either. One person’s support plan recorded that they were at risk of dehydration. While a fluid chart had been put in place to record fluid intake, the support plan did not include details of how much the person should be drinking and provided no guidance to staff on when to seek medical advice.

Support plans were signed as being reviewed regularly, but we received mixed feedback from relatives with some telling us they had not been involved in reviews.

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

The service used clinical tools such as weight logs, food and fluid charts, bowel movement charts and ABC charts; although we found concerns regarding the completion of the some records such as fluid records, we found some of the other records had been completed to a higher standard.

One person’s support plan recorded that staff are to offer a drink every hour and fluid intake to be recorded on a fluid chart. We reviewed the fluid charts and found that there were gaps, and drinks had not been recorded as offered hourly.

However, bowel monitoring records were recorded thoroughly, and actions had been taken where concerns had been identified.

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.

Staff worked collaboratively with health and social care professionals. We received positive feedback from external health professionals; one person told us, “I have found the staff at Harvey Lane very responsive and helpful whenever I have contacted them.” While another person told us, “The team, work in a highly professional manner with external professionals, communicating clearly, sharing relevant information appropriately, and engaging constructively to ensure the best possible outcomes for the individuals supported”.

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.

We received mixed feedback from relatives. One person told us, “I don't get any information about medical appointments but as far as I know [they] were supposed to go to [a slimming club] but hasn't and [their] weight is a concern to us”. While another relative told us, “They have cut [their] chocolate and fizzy drinks down as [they] are overweight”.

We observed that people were offered a range of choices for their meals and that staff supported and encouraged people with their decisions.

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 and

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

While monitoring records were in place, we found that there were some inconsistencies with the completion of the records, which had not been identified by the service. Meaning that opportunities to improve care and treatment could have been missed.

Despite this, the service worked well with healthcare professionals in regard to people’s behaviours, medication and mental health concerns.

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

We found that there was a lack of governance oversight and that consent to care and treatment had not been lawfully obtained in accordance with the Mental Capacity Act 2005.

Where required, people had Deprivation of Liberty Safeguards (Dols) in place or applied for.

Mental capacity assessments and best interest decisions were either not completed, reviewed or contained inaccurate information. For example, for one person’s Mental Capacity assessments were dated 2023 and had not been reviewed. There was a lack of best interest decisions completed. None had been completed for consent to care, treatment, information sharing and/or the use of photography. Governance systems in place had failed to identify these shortfalls in care records.