Compton Manor

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

This meant we looked for evidence that people’s care, treatment and support achieved good outcomes, promoted a good quality of life and was based on the best available evidence.
At our last assessment, we rated this key question good. At this assessment, the rating remained good. This meant people receive care and support that consistently achieved effective outcomes.
 

This service scored 63 (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 consistently assess, review and accurately reflect people’s health, care, wellbeing and communication needs.
Staff did not always ensure care plans fully reflected people’s preferences, routines, and risks. Staff did not consistently maintain complete or up to date records, for example we found gaps in daily documentation. This meant records did not always reflect people’s current needs or the support provided, which reduced continuity of care and increased the risk that staff did not have consistent information to guide decision-making.
Staff did not consistently involve people or their relatives in care plan reviews, and they did not always formally record changes in needs following review. Most relatives we spoke to fedback that they had not been involved in care plan reviews. One relative told us: I haven’t been involved in care plan discussions or formal reviews”, another relative said “I have not been involved in a review or seen their [relatives] care plan”. One person said, “I’ve never seen my care plan.” Another person told us, “I don’t know what that [care plan] is.” This reduced assurance that care planning was consistent person-centred and reflective of current needs.
However, staff demonstrated a good understanding of people in practice. Staff described people’s preferences, routines and risks, and we observed care delivered in line with this knowledge. Relatives also spoke positively about staff understanding people’s needs. One relative said, “They know what [my relative] needs and how to support them.” This showed staff had developed positive relationships and understood people well, but leaders had not ensured this knowledge was consistently recorded and shared.
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Although this was not always consistent across the service.
Staff used nationally recognised tools such as the Malnutrition Universal Screening Tool (MUST) to assess nutritional risk and the Waterlow score to assess the risk of pressure ulcers. This demonstrated a structured and evidence-based approach to identifying and monitoring people’s clinical risks. Staff demonstrated a good understanding of people’s dietary needs and associated risks. Kitchen systems were well organised, with food stored safely, labelled correctly and temperatures monitored. Kitchen staff demonstrated good knowledge of food hygiene and individual dietary requirements. External professionals provided positive feedback about outcomes for people, particularly in relation to improvements in independence where staff followed guidance consistently. One professional described staff as “knowledgeable and consistent in their approach.”
People’s nutritional and hydration needs were generally met. During the inspection, we observed staff providing appropriate support mealtimes, offering assistance where required and demonstrating awareness of individual needs and preferences.
 

The provider did not always work well across teams and services to support people. Information was not always effectively shared, and collaboration with external partners was inconsistent.
Partner agencies raised concerns about how the provider communicated and progressed actions. One partner agency told us the provider was not always proactive in sharing information or following up actions after hospital discharges. A partner raised concerns about a lack of proactive communication and follow up. One partner told us they found it difficult to establish a consistent working relationship. This reduced assurance that staff coordinated care effectively across services, particularly when people’s needs changed.
We received feedback from another professional stating that the provider could appear “closed” in their approach, which impacted partnership working. This limited opportunities for open communication and joint planning, and meant partners did not always feel confident they had a clear understanding of people’s current needs or care arrangements.
Internally, staff did not consistently maintain accurate and up-to-date care records, and gaps in documentation reduced assurance that staff shared information effectively across the team. This increased the risk that staff did not always deliver care based on current information.
However, there were some examples of effective joint working. Some external professionals told us care staff were responsive and worked appropriately with them, particularly where staff followed guidance to support people’s independence. Staff described how they contacted external professionals when needed, and some records showed that staff made appropriate referrals. This demonstrated that systems were in place, but staff and leaders did not apply them consistently.
 

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.
People’s day-to-day health needs were generally met. Staff demonstrated a good understanding of individuals and their health conditions, and external professionals gave positive feedback about the support provided. One professional told us staff were “quick to notice changes and act on them,” which showed staff responded promptly to changes in people’s health and wellbeing. One person told us, “They help me stay as healthy as I can.”
Staff supported most people to access healthcare services where required and worked with professionals to respond to changes in people’s needs. There was evidence that staff made referrals and followed professional guidance to support people’s health outcomes. People were also supported with their nutrition and hydration, and staff understood individual dietary needs and risks.
However, the provider could not always demonstrate through records how staff consistently monitored and reviewed people’s health and wellbeing over time. While staff clearly knew people well, staff did not always support this with clear and consistent documentation. This reduced assurance that there was a fully robust and proactive approach to recording and evidencing how people’s health was maintained and improved.
 

The provider did not always routinely monitor people’s care and treatment to continuously improve outcomes. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.
Systems to monitor and evidence outcomes were not always robust or consistently applied. Staff did not consistently complete care records, which limited the provider’s ability to track outcomes over time and evaluate whether care remained effective.
There was limited evidence that the provider used feedback from people, relatives and professionals to improve outcomes. While some professionals gave positive feedback, others raised concerns about communication and follow-up. The provider did not demonstrate how this feedback had been used to drive improvement, which reduced assurance that outcomes were consistently reviewed.
Staff did not always evidence how changes in people’s needs led to clear actions or measurable improvements, and records did not consistently show how care was evaluated over time.
However, we saw examples of positive outcomes when staff followed professional guidance. One professional told us, “We’ve seen a real improvement in their mobility.” One person said they would not be mobile without staff support. This showed outcomes could be achieved, but systems to monitor and sustain them were not consistently embedded.
 

The provider told people about their rights around consent and generally respected these when delivering person-centred care and treatment.
People and relatives described being involved in decisions about their care. One relative told us, “They always check with them first and explain what they are doing,” which showed staff usually sought and obtained consent before providing support. During the inspection, we observed staff asking for consent before delivering care and respecting people’s choices, including when a resident declined support.
Care plans recorded people’s capacity to make decisions, and where appropriate, staff involved lasting powers of attorney in care planning. Staff documented best interest decisions, and the provider had policies in place to guide staff in line with the Mental Capacity Act (MCA). Staff used person-centred tools, such as respect forms, to support decision-making. This demonstrated that systems were established to support lawful and appropriate consent processes.
Staff demonstrated a good understanding of people’s preferences and choices in day-to-day practice. Where people chose not to take medicines or engage in care, staff respected these decisions and responded appropriately, which supported people’s autonomy and right to make decisions about their care.