SCC Adult Social Care Supported Living and Mallow Crescent short breaks service

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

We identified a breach of regulation in relation to consent and how the principles of the Mental Capacity Act 2005 were followed. Best practice guidance was not always followed which meant people were not always fully involved in their own support and there was a risk people’s rights would not be upheld. Not all staff were aware of the principles of the Mental Capacity Act 2005 and processes were always followed to ensure capacity assessments and best interest decisions were recorded. The support people received was not always reviewed with them to determine any goals they wished to achieve whilst staying at the service. For some people we found they had received support to try new experiences and take advantages of opportunities. Assessments were completed prior to people starting to use the service to ensure their needs could be met. Staff were aware of people’s needs in relation to their health. We observed staff provided people with day to day choices and asked for consent prior to providing support.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People needs were assessed prior to them starting to use the service. This was a collaborative process and information was gathered regarding people’s preferences.

Staff and leaders told us they ensured people’s needs were robustly assessed prior to them starting to use the service. One staff member told us, “We not only assess people’s needs to check we can meet them, but we also have to be sure they will get on with other. It’s not just about meeting needs but also making sure everyone will be happy here.”

Following referrals being received from the local authority assessments took place to ensure people’s needs could be met and that they would feel comfortable staying at the service. A standardised process was used to gather all the information required and involved people, their relatives and staff comments following people’s visits. The service had a policy of not accepting people for emergency stays unless they had already been assessed and were known to the service. This was to minimise risks to both the person and others staying at Mallow Crescent.

People told us they enjoyed their visits to Mallow Crescent. However, we observed a number of occasions where people were spoken to in a child like manner which did not demonstrate an understanding of best practice guidance.

Staff we spoke with were not aware of best practice guidance such Right Support, Right Care Right Culture or how this impacted on their work.

There were no systems in place to review people’s support in line with Right Support, Right Care, Right Culture. As highlighted in other areas of this report we found some staff spoke to and about people in a way which did not demonstrate an understanding of people’s rights as an adult. In other instances, people were supported in a person centred and respectful way.

People benefited from a staff team who worked together to ensure they received support. We observed staff communicating with each other to discuss what was happening to ensure people were able to go out should they wish. People received support from regular staff members which was reassuring for people due to the nature of the service where people visited for short breaks.

Staff told us they felt there was good communication and relationships within the staff team. “We were told, “We’ve (staff) have got a good rapport, including the night staff. We do handovers with them and write in the notes, so everyone is aware of what has happened.”

Professionals told us the staff they spoke with were always helpful and polite in their responses. They were able to share information and ensure they were directed to the correct staff members to speak with.

Regular team meetings were held with staff to discuss both the support provided and the systems in place. In addition, staff completed handovers at the change of shifts. As part of this process, staff worked together to plan the day to ensure people received support and additional tasks were completed.

People healthcare needs were known to staff and relatives confirmed these were discussed as required.

Staff told us they tried to promote healthy lifestyles whilst people were staying at Mallow Crescent. One staff member told us, “We go out for walks where possible and encourage healthy eating options. If any service users have a specialist diet we will always follow that.”

Processes were in place to ensure staff were aware of people’s health care needs and the support they required. On the whole people attended health appointments when at home. However, where emergency health appointments were required, these were arranged by staff to ensure people received treatment promptly.

The service had a positive impact on people and their relatives by providing a safe place and support to have a short break, providing the opportunity to both parties to do different things.

We did not gather any direct feedback from staff in relation to this. The management team told us no specific goals were set with people in relation to their stays at the service.

There was no record of discussions with people regarding anything they wished to achieve during the time they spent at Mallow Crescent. People’s care records did not contain reviews of their time at the service in order to measure outcomes or achievements. From our observations it appeared people were offered choices regarding how they spent their time.

People were generally asked for their consent prior to support being provided. However, we observed one person being told how they needed to ‘behave’ and what they should do. Staff told us this was because the person needed firm boundaries. However, there was no indication in the persons records of this approach being agreed.

Staff were not aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). Staff we unable to describe the MCA process and some staff felt this was not their responsibility despite the service being responsible for people’s care whilst they were staying at the service.

There were no processes in place in relation to protecting people’s rights in line with the MCA. No capacity assessments or best interest meetings had been completed by the service to review restrictions in place such as people receiving 24-hour support during their stay. Staff were unaware how or when this documentation should be completed with people. We found that on the whole staff asked for people’s consent prior to supporting them. However, restrictions such as people being expected to retire to their rooms by 11pm were not looked at to assess if other arrangements could be made with people.