Frank Care Devon

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.

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

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.

Each person had a care plan. The care plans were adequately structured, but the content sometimes lacked detail and was sometimes inaccurate. This was particularly important where a person had more complex needs.

Care staff were not adequately informed about each person’s care needs by the person’s care plan before they began working with a person. A person said, “New carers (care staff) don’t know my needs. There’s not enough shadowing first. It depends on who is working. They (the care staff) try. Some are more competent (than others)”. A staff member confirmed they were inadequately informed to carry out their work, “No, there is often insufficient or outdated information in care plans and risk assessments. This makes it difficult to manage risks effectively and safely, especially when dealing with vulnerable service users (people)”.

However, there were some good photographic directions for staff on how to place pressure cushions for a person with complex needs to keep them safe from pressure area skin tissue breakdown. Some aspects of care planning were appropriate to meet this person’s needs.

The provider planned and delivered some people’s care and treatment with them, including what was important and mattered to them. They did this in some cases in line with legislation and current evidence-based good practice and standards.

Some aspects of care delivery were affected by poor planning at provider level, and this impacted peoples' outcomes. For example, where lateness caused distress or anxiety.

People were supported with their personal interests and specific needs as defined by their care planning.Some people required substantial physical and emotional support. Records were kept, showing the delivery of aspects of care and support. These records could enable trends and issues to be identified, to then update people’s care planning.

The provider did not always work well across teams and services to support people. There was a poor culture within the staff team caused by the management’s approach and actions, which caused poorer outcomes for people using the service.

The service had not worked constructively with some stakeholders in the health and social care system such as the local funding authority and when information had been requested relating to concerns raised. The provider did not always turn up to meetings involving stakeholders.

However, the service was working effectively with health and social care professionals involved in each person’s direct care. The service was holding team meetings amongst the staff, to ensure changes in peoples' needs and circumstances were communicated to all staff delivering each person’s care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Some peoples' food and drink intake was being monitored to ensure their health was supported. This enabled issues and trends to be identified and appropriate interventions to take place, such as contacting the person’s GP and health services if necessary.

The provider routinely monitored peoples' care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service was monitoring the outcomes for each person supported by the service. One person who had complex health and care needs had the involvement of a multi-disciplinary group of professionals. The service supported the monitoring of this person’s ongoing care and fed back to this group on changes the service identified. The person’s relative said, “The carers (care staff) will tell me about any red marks or catheter bag leaks and we’ll call the nurse in if needed. I have been told once by the carers (care staff) to call the G.P when (the person) didn’t look right. He (the care staff) called an ambulance”.

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

The service systems and processes had not identified some staff were not always offering people choice in their care. Most people said being offered choice in their personal care was not an issue for them, but one person said, “Usually they ask me (to consent to care) but not all of them. New ones especially don’t ask but just do. I do mind and get upset. I told them and they stopped”.

The service had Mental Capacity Act 2005 policy and procedures in place should the need arise to apply it with people using the service in the future.