Summerfield Court

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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.

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.

The service was in breach of legal regulation in relation to consent to care and treatment.

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 did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People had care plans and assessments in place that broadly described their health, care and communication needs. Staff demonstrated areas of good day‑to‑day knowledge of people’s needs and requirements, but we also found areas of inconsistent knowledge such as who were the people who lived at the service had a DoLS in place. We also found gaps and inconsistencies in some assessments. This meant that although assessments were in place, they did not always fully inform safe, effective and person‑centred care.

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

We found limited evidence that therapeutic and rehabilitation input was consistently embedded into people’s day‑to‑day support. The service was a specialist brain injury service, however there was little evidence of structured rehabilitation plans focused on outcomes for people. This reduced people’s opportunities to maintain or improve skills and independence and did not reflect best practice for people living with brain injuries.

Some people received appropriate support from external professionals such as GPs, occupational therapists, speech and language therapists and social workers. Where guidance was in place, staff generally followed it, for example in relation to dysphagia management and timed medicines administration. However, some healthcare professionals also raised concerns about staff not always following professional guidance.

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.

Staff had contact with healthcare professionals when concerns were identified, and some multidisciplinary working was evident. However, relatives and professionals gave mixed feedback about how well information was shared and coordinated.[WB1] A relative commented, “Appointments have been missed for the dentist and the orthopaedics. They have now been rebooked and there have been small improvements in things recently.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were supported to attend medical appointments and received assistance with nutrition, hydration and daily living activities. However, our review of records and feedback from people, relatives and healthcare professionals indicated inconsistent support with healthier lifestyles, including diet, physical activity and meaningful engagement.

There was limited evidence that people were supported to maintain or improve physical function, independence or long‑term health outcomes. In some cases, staff and relatives told us people’s mobility and independence had declined over time without clear evidence of proactive intervention. This meant opportunities to promote health, wellbeing and independence were not always fully explored.

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.

We found limited evidence that people’s goals, progress or outcomes were routinely reviewed and updated. Some care plans contained goals, but there was little evidence these were consistently monitored, evaluated or adapted.

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

People told us staff sought their consent where possible. However, we found multiple concerns with how capacity, best‑interest decision‑making and restrictions were managed.

Some people were subject to restrictions, such as supervision levels or limits on access to the community, finances or personal choices. There was no evidence of completed mental capacity assessments for specific decisions and best‑interest decisions involving relevant people. Healthcare professionals also raised concernsabout how the provider’s understanding and application of the requirements of the MCA. One healthcare professional commented, “Their documentation (on mental capacity and best interest decisions) can be contradictory and their understanding of capacity assessments also.”

We found oversight of MCA and DoLS was not effective, and staff did not always understand or consistently apply legal requirements. This placed people at risk of having their rights unlawfully restricted.