The Coach House SBDP1 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. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained the same. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (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. Assessments of people’s needs was not thorough, and the assessment records we reviewed were not always completed fully. We saw parts of the assessment forms were left completely blank, however, other parts of the form had been completed with a good level of detail, for example we saw a person’s family history had been completed in collaboration with a family member.

The provider had an electronic care planning system in place where people’s care and support was documented. This also included evidence-based tools to determine people’s nutritional risk and another tool to determine people’s risk of developing pressure ulcers. A review of records showed these were not always being completed. This meant risks in relations to people’s care needs were not always planned for in a way to minimise harm. However, family members told us they were involved in the planning of their relatives care with one saying, “We were involved and told them how we wanted him to be cared for.”

The provider did not always work well across teams and services to support people. We saw an example of when a prompt referral was not made for one person who required specialist input for a care need. Some family members told us they were not always kept informed of changes to their relatives care needs. However, other family members reported they were regularly updated, with one family member describing the staff as, “Exemplary.”

We were told by some family members how staff liaised well with other healthcare professionals to ensure their relatives needs were met.

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 not always supported to maintain nutritional intake in line with their needs. Where people’s food and fluid intake was being monitored, there was no rationale for this. Fluid records also did not specify a target intake, so we could not be assured people were drinking enough for their individual needs.

Records showed people were supported to see the GP and family members we spoke with confirmed this, with one telling us the GP was in regularly.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. We saw that people’s care plans and risk assessments were not always reviewed regularly. Information in people’s care records was also inconsistent as our review of records showed information in people’s care plans did not correspond with that in associated risk assessments. People’s aspirations and outcomes were not always detailed in their care records. However, some family members reported positive experiences with one telling us their relative’s health and wellbeing has improved since they have been living there as the staff listened to the family member’s recommendations.

The provider did not always work in line with the principles of the Mental Capacity Act (MCA) 2005. We saw two people were sharing a room and both lacked capacity to consent to this and there were no MCA assessments in place for this. Since the inspection the provider has provided assurances this has been completed and the people’s families have been consulted.

We saw MCA assessments and associated best interest decisions had been completed, but associated care records did not specify how people could give consent and failed to detail when staff should ask for consent where a person has fluctuating capacity.