Aspire Hub 1

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 46 (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 had not regularly reviewed their care needs with them to ensure their needs were understood and were up to date. Some people and their relatives told us care was planned with them to understand people’s needs however others felt their care and treatment plans were not followed effectively. Reviews and consultations with people and their relatives were carried out however, these were not always completed in a timely manner. For example, one person had not had an annual review since August 2022.

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. Incidents and accidents were recorded; however, actions were not always followed up. For example, there were incidents where the provider had recorded “incident to be discussed in staff meetings and staff supervisions”. We reviewed meeting minutes and supervision records, and this had not always been done. One staff member had made 5 medication errors within 12 months, and their supervision record advised further training was required however, this training did not occur therefore lessons were not learnt.

Oversight to identify trends and themes was not robust. In some instances, records did not include the staff member’s name who was involved in the incident and the date the incidents happened to identify common themes.

Some staff told us they were not informed of actions taken when they had reported incidents. Comments included, “We report concerns to management about neglect of people, and they don’t do anything. They hardly ever feedback about incidents or trends” and “We don’t hear back about incidents we report. We fill out a form and give it to management and they take over. I don’t know what happens after that.” One relative stated, “I report things they don’t address them.”

It was evident through observations that staff knew the people they were supporting well, however, they did not always have sufficient information available to them in risk assessments to understand how to mitigate all risks. We found examples where lessons learnt from incidents were not always shared with staff to improve practice.

People with a learning disability and/or autism were provided with a hospital passport. This is a document that provides healthcare staff with information about a patient’s specific needs, preferences and communication style to ensure they receive the most appropriate care when moving between services. This is good practice to help ensure people who are less able to communicate their needs are supported to do so.

The provider did not always support people to manage their health and wellbeing. The service did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. For example, one person using the service had gained 20kg and there was no risk assessment or guidance for staff on how this was being monitored to reduce their weight. There was no record of weights to ensure it did not continue to increase and contribute to physical health deterioration. In addition, the care plan advised staff to ensure they received a healthy diet; however, this was not always evidenced within nutrition charts. We received mixed responses from people and relatives in relation to people’s nutrition one person said, “Choices are not respected. People don’t know how to cook, [Name] has tinned meatballs and cheap sausages, easy things to do.”

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. There was not a robust approach to monitoring the effectiveness of people’s care, treatment and support and action was not always taken to continuously improve. One relative said, “I think they (staff) understand but don’t stick to the plan. There is a lack of consistency, and the support plan is not followed for food” and “We are worried about them not following the support plan. It’s a risk how much food [Name] eats in total, [Name] overeats and doesn’t understand and puts weight on.”

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. Incidents and accidents were recorded; however, actions were not always followed up. For example, there were incidents where the provider had recorded “incident to be discussed in staff meetings and staff supervisions”. We reviewed meeting minutes and supervision records, and this had not always been done. One staff member had made 5 medication errors within 12 months, and their supervision record advised further training was required however, this training did not occur therefore lessons were not learnt.

Oversight to identify trends and themes was not robust. In some instances, records did not include the staff member’s name who was involved in the incident and the date the incidents happened to identify common themes.

Some staff told us they were not informed of actions taken when they had reported incidents. Comments included, “We report concerns to management about neglect of people, and they don’t do anything. They hardly ever feedback about incidents or trends” and “We don’t hear back about incidents we report. We fill out a form and give it to management and they take over. I don’t know what happens after that.” One relative stated, “I report things they don’t address them.”