Chasfab Options Limited

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.

This is the first assessment for this service. This key question has been rated 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 was effective, because they did not always check and discuss people’s health, care and wellbeing and communications with them. Assessments were caried out prior to people receiving care, and the home environmental risk assessments were robust. The service supported people with severe learning difficulties, however, there was no evidence that NICE guidance was followed during the creation of care plans for these people. At the time of the assessment, 1 person using the service was able to communicate effectively and independently. However, there was no evidence this person was involved in the creation of their care plan, or had their views heard on how they wanted to received care and support. People’s capacity to consent or to be involved in the development of their care was not assessed or documented and decisions about people’s care was made without the service attempting to gain people’s input. This left people at risk of not having their views or wishes taken into account in relation to the support they received.

People with additional support needs for nutrition and hydration did not have tools in place to document and monitor food intake, or fluid intake and output. For example, 1 person required their fluid intake to be monitored to reduce the risk of dehydration. Although daily care notes stated fluids were given throughout the day, the quantities of fluid given, taken and passed was not monitored. There were no tools in place for fluid or dietary activity to be recorded. This risked staff being unable to accurately monitor intake and output, putting people at the risk of a deterioration of their condition and the risk of avoidable harm.   

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. People’s relatives and staff told us they had access to care plans. However, some care plans did not contain enough detail to inform staff how to keep people safe. Care plans did not always distinguish between tasks to be carried out by staff, health care professionals or relatives involved in supporting people. This increased the risk of staff being unclear of what tasks they were expected to complete to keep people safe, increasing the risk of avoidable harm.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Healthcare professionals told us the service worked well with them to ensure people had access to healthcare. However, while relatives where happy with the care and support being delivered, there were no medical risk assessments in place to aid staff to support people safely. For example, we saw care plans which stated people needed support with epilepsy, but there was no assessment in place to inform how to reduce the risk of seizures or manage a seizure once they occur. Nor was there information around administering medication if required or what to do if seizures did not follow their expected pattern. People’s capacity to consent to care was not documented to have been assessed and reviewed with them. Care plans were created without people’s input, and they were not involved in the reviews around their care and treatment This lack of reporting and documentation left people at the risk of being supported by staff who were not able to assist them in making choices to live healthier lives.

 

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Staff supported people to attend school and college throughout the day. However, some care plans did not document people’s future goals or aspirations. Where goals were documented, staff were not informed on how to help people achieve this. For example, a care plan informed staff to keep people engaged and not allow them to be bored with communication. However, there was no information about peoples likes, or dislikes, and what might interest them. Progress or lack of progress in relation to communication had not been documented, so staff were poorly informed. Audits completed by the service did not identify errors we noted in care plans. The need for risk assessments and medicines administration records for some people were also not identified as being required by the service. The lack of effective monitoring left people at the risk of their support needs not being met appropriately.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.  Relatives told us, their wishes in relation to the care people received were taken into account. However, we saw people being supported with no evidence their ability to consent to care in relation to their rights under the Mental Capacity Act had been assessed or implemented. This left people at risk of being receiving support in a way against wishes they may have.