Lambeth Chinese Community Association

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 inspection 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 50 (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 peoples care and treatment needs was effectively captured in their care plans and risk assessments.We saw plans which stated people required additional sensory support, but the plans did not inform staff on how to support people in relation to this. People’s capacity to make their own decisions was not clearly documented by staff. This left people at risk of being supported by staff who did not know how to support them in line with their needs and preferences.

The registered manager told us they worked closely with social workers and care professionals to ensure people’s needs were robustly assessed before the delivery of care. The service completed visits with people and their relatives to ensure they were able to deliver a person-centred care package to people suiting their social and cultural needs. However, this information was not effectively documented. Some people and their relatives told us they were involved in the care planning process, and they could request changes to people’s care needs as required. Others said they were not sure if they were involved in the planning of their care. However, they were happy with the care they received from the service.

The provider did not ensure evidence-based care and treatment was delivered. The provider did not ensure staff understood current legislation and national standards in the delivery of care and treatment.Before this assessment records showed the most recent certified training for staff dated from 2018. This meant staff were not trained in current standards of care delivery.

Care plans stated staff were to support people with their meals but did not include person centred information about people’s nutrition and hydration needs. For example, care plans did not specify types of foods people preferred or how staff should prepare this for people in line with their support or cultural needs.The registered manger told us they took time to ensure people’s nutrition and hydration needs were met, and in line with their cultural preferences. This was discussed before support was delivered and staff were aware of how to support appropriately. However, this information was not documented on care plans or risk assessments.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.The information recorded in some care plans was ambiguous and provided limited person-centred information. For example, where care plans referred to people living with dementia, there was no personalised information recorded about their specific care they required, how their dementia might affect their day-to-day activity. It did not inform staff on how they should manage any change in behaviour they might recognise. This meant staff did not always have sufficient information to support people appropriately in line with their care needs. There was no documented evidence of multidisciplinary intervention to support people with their specialised care needs.

Staff told us there was effective communication within the staff team and management to ensure they were able to deliver care effectively. Staff told us they would ask the registered manager if they had any concerns in relation to this.

Some people told us they would work with their housing support manager to assist with their care support needs if required.

The provider did not always support people to manage their health and wellbeing effectively. We reviewed a risk assessment which advised staff not to complete a visit should a person have visitors in their home due to risk. However, there was no information on steps that should have been taken to ensure this person did receive their care visit, leaving them at risk of not having the care and support they required to support them in living a healthier life. People’s capacity to consent to care was not documented to have been assessed and reviewed with them. This lack of reporting and documentation left people at risk of being supported by staff who could not assist them in making choices to live healthier lives.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. The care plans briefly documented people’s social goals as ‘for a person to live independently in their home for as long as they can.’ But actual steps of how this was to be achieved was not documented.

The service did not have audits in place to review the overall running of the service.We raised this with the management team who told us that audits of the service were not in place at the time of the assessment.

Staff told us they monitor people as they were delivering care and will feed back to the families or registered manager as required.

The provider did not ensure staff were sufficiently trained to support people in line with their rights around consent to their care and treatment.

Staff had not received the appropriate training to support people with consent to care.

The provider had not provided training in the Mental Capacity Act (MCA). This left people at risk of being supported by staff who did not fully understand how to inform people of their rights under the MCA. The management team confirmed this training had not been delivered to staff at the time of the assessment. However, some staff were able to explain the MCA was around supporting people with their rights to make decisions.

Care plans did not document people’s mental capacity to make decisions for themselves in relation to care and treatment.Care plans did not document people’s advance care and support needs or decisions. However, staff told us they understood to gain consent from people wherever possible. A member of staff said, ‘I always ask for consent before providing care, observe verbal and non-verbal responses and respect [people’s] wishes.’

People told us that staff always sought consent before beginning personal care.