Social Care Solutions (Raunds)

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• 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.

This is the first assessment for this service. This key question has been rated good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (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 assessed before they started using the service to ensure they could be appropriately supported. Support plans contained lots of information, however, these did not always give specific guidance to support staff to deliver the care needed.

We found support plans were not always easily understandable due to the amount of information they contained, and there was some conflicting information. We found that not all support plans had been updated. For example, one eating and drinking support plan said snacks were kept in the office. However, we found this had changed and they were kept in a person’s flat.

There had been a lack of effective oversight from leaders in relation to the governance and auditing of care plans to ensure these provide staff with specific and accurate guidance.

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

The provider was monitoring the weight of a person monthly due to the risk of obesity associated with their medical condition. We found the service had guidance from the GP who had specified a maximum weight and staff were monitoring this monthly in line with guidance from a medical professional.

We found staff had good knowledge of the risk associated with the person’s medical conditions. However, there was no specific risk assessment in relation to this nutritional risk, or the control measures in place to mitigate this. Staff were not aware of a nationally recognised (or the provider’s own methodology) tool being used to assess the nutritional risk. For example, BMI or MUST.

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.

The provider was committed to ensuring people only needed to tell their story once and had introduced an online care planning system which enabled them to share information between different services, if required.

We found that staff worked together and knew the people they were supporting well. There was a handover process, and we saw evidence of staff communicating through formalised electronic handover practices.

The service had introduced champions to support each other in specialist areas, and we saw evidence of champions for safeguarding, health and safety, finance and medicines. A staff member told us, “I feel supported by my colleagues and we can work through any concerns together as a 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.

We found there was evidence of meal planning. A team leader told us, “Staff came up with the meal planner and with pictures of the meals [service user] enjoys. It is a balanced planner. These help [service user] pick a meal.”

People were supported to access healthcare services and staff worked collaboratively with external professionals to support people to attend medical appointments. We saw evidence a person was attending regular dental, chiropody and opticians’ appointments. We found a person was also supported to have regular medicines review with their GP.

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 was identifying outcomes from people as part of the support planning process through a specific goals and outcomes support plan. The support plan included goals linked to health and well-being, and aspirational goals such as a holiday and travelling . There was some evidence provided of achieving these goals, for example, a new mobility car.

A relative told us, “[Service user] speech was terrible” when they moved in. “Every now and then I hear [service user] say a new word and it surprises me. The other day [service user] was sat in the car and said to staff member, [staff member] I’ve done it. [staff member] Asked, you’ve done what? [service user] responded, mop the floor. I’d never heard [service user] use these words before. Was so proud of himself.”

Although there was further work to do to continue to monitor and evaluate goals and ensure support plans provided specific guidance for staff on how people wanted to achieve their outcomes. We found a positive foundation of goals and aspirations to build on.

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

The provider had assessed people’s capacity, and we found there were a range of mental capacity assessments (MCA) and best interest (BI) meetings for individual decisions. However, those we reviewed for a person had not always been completed in line with the 2-stage test of capacity set out in the Mental Capacity Act.

There was not always evidence in the MCA’s and BI decisions to evidence how the person, their relatives or representatives had been involved, or where applicable, how their communication needs had been considered to help them understand the decision that needed to be made.

We found that some MCA’s and BI decisions had been completed for decisions that were not required, for example, the seat belt in a vehicle and fan in a flat. There were other MCAs and BI decisions for restrictions that were required and not in place, for example, a person’s snacks being locked in a cupboard in their flat.

We received conflicting information from leaders, staff and in support plans in relation to whether relatives held Power of Attorney for people supported by the service.

We discussed our findings with the interim manager and were assured they would be able to support the team to address our findings.