Osmund Court (Care Outlook)

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 newly registered 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 58 (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. Assessment and review processes were not consistently robust, and some key risks were not identified and therefore not managed or reviewed. For example, initial assessments did not consistently record important health risks, which meant staff did not always have the information needed to plan effective care from the outset. The provider shared details of improvements they were making to the assessment process, “Up to this point we have not used a pre-assessment document to record this in a single place. We have however created a pre-assessment record which we will use moving forward to evidence this process and make a record of initial conversations about the person and with the person.”
Staff and professionals described strong collaborative working once peoples support commenced and people frequently experienced improved health and mobility. One family member told us how managers and staff had supported their loved one, “[Named person] has come on in leaps and bounds as a result of the great care they received.”

The provider did not always ensure care and treatment were delivered in line with evidence‑based practice. Care plans were generally person‑centred and included detailed information about mobility, skin integrity, continence and equipment. Professionals described staff as, “Knowledgeable, responsive and willing to seek advice”, and spoke positively about partnership working with therapists and specialist nurses. However, the service did not apply clinical tools consistently across all high‑risk individuals. For example, clinical tools were not routinely in use, even where people had clear pressure‑related or nutrition risks. There were also gaps between care plan detail and recorded monitoring in daily notes, meaning it was not always possible to evidence when escalation to health professionals occurred in response to deterioration.

The provider worked well across teams and services to support people. The provider made sure people’s care benefitted from strong multidisciplinary working. Health and social care professionals reported very positive coordination, highlighting effective partnership working with OTs, physiotherapists, GPs and specialist nurses. A health professional told us, “The registered manager will always partnership work with [people] and ask for guidance and advice if they are unsure.” Another health professional described how staff worked in partnership with them to support a person at the end of their life, “There was a lot of partnership working with nurses and health colleagues to ensure this customer was able to remain at home until the end.” This contributed to positive outcomes for people.
People themselves spoke about the meaningful improvements they experienced as a result of integrated working. For example, one person was described to have improved mobility following the team working closely with health professionals. Records and feedback indicated that staff worked well with external partners to review care, plan interventions and escalate concerns where necessary.
 

The provider supported people to improve and maintain their health, independence and wellbeing. People and relatives described significant improvements in physical function following sustained support from staff and therapy teams. Health professionals consistently told us staff knew people well and recognised deterioration, escalated appropriately, including to emergency services when required. Staff engaged proactively with specialist teams, such as Parkinson’s nurses, community therapists and GPs, to ensure people accessed the right support at the right time. This contributed to positive experiences and improved health outcomes.
People said staff supported them to live healthier lives. One person told us, “They noticed a change to my skin and helped me to make an appointment with the GP.” While monitoring tools were not always consistently embedded (for example in nutrition and bowel management), the feedback clearly showed that staff enabled people to live healthier lives and regain independence through personalised, recovery‑focused care.
 

The provider did not consistently demonstrate how it monitored people’s outcomes or used this information to drive improvement. Although people frequently experienced improved wellbeing and mobility, documentation and audit systems did not reliably evidence this progress. For example, medicine audits did not identify recurrent timing errors for time‑critical Parkinson’s medicines. Care plans described monitoring expectations for skin integrity risks, however, records did not always show when staff escalated concerns or contacted professionals. This limited the provider’s ability to monitor emerging patterns or evaluate the effectiveness of interventions. Despite these gaps, professionals noted that staff were responsive to deterioration, and people reported improved health. The registered manager and provider told us how they were working to strengthen monitoring frameworks to help the service capture and evidence the positive outcomes staff are achieving in practice.

The provider did not always ensure people’s rights were upheld through consistent application of the Mental Capacity Act (MCA). While staff supported people respectfully and with dignity, decision‑specific capacity assessments were not consistently completed, particularly for individuals who had fluctuating capacity. Some care plans stated that people had capacity. However, the registered manager and staff described individuals as needing staff to administer their medicines to keep them safe. This inconsistency suggests uncertainty about the person’s capacity, and there were no linked MCA assessments to support or clarify the decision-making.
There some shortfalls in risk assessments for complex decisions, such as alcohol use alongside Parkinson’s medicines, which carry known clinical risks. Documentation did not demonstrate how staff assessed capacity, how best‑interest decisions were made, or how people were involved in those decisions. This lack of clarity also meant there was limited evidence of how the service supported individuals with positive risk taking in line with their wishes. The registered manager told us of their plans to improve MCA practice with regards to decision‑specific assessments and clear recording of people’s choices, to improve assurance that consent processes met legal requirements and supported people’s rights.