CSL Spilsby

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People’s needs were assessed prior to admission, with findings used to inform care planning. This proactive approach ensured that care delivery was tailored to individual requirements from the outset.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. Care was delivered in line with people’s preferences, promoting both safety and effectiveness. Nonetheless, care plans sometimes lacked depth in some areas such as guidance for staff around how to support people’s distress or consistency of approaches to achieving goals and aspirations. Improvements were needed to eliminate repetitive content and enhance guidance for staff.

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. A relative told us about the work staff did with other services to support their family member when their health deteriorated. They told us staff were, “Really supportive and tried to help as much as possible.” Staff worked collaboratively across disciplines, using integrated approaches to provide coordinated and person-centred support. This ensured that care was not only clinically appropriate but also aligned with what mattered most to people. Staff were confident to challenge when other providers requested treatment plans that were not safe or in-line with the person’s best interest.

The provider’s policies promoted people to manage their health and wellbeing to try and maximise their independence, choice and control. Staff generally supported people to live healthier lives where possible to reduce their future needs for care. However, despite people being able to access swimming and walking, and healthy, varied meal plans being prepared, staff and relatives all raised concerns with us about the lack of consistency when encouraging healthy eating and exercise in practice, leading to some people gaining weight that impacted their mobility and well-being. For example, they told us how some staff followed the care plan and others did not. They said people were not always being educated about the impact of gaining weight. We saw that 1 person had gained weight and were told by relatives and staff this had impacted their ability to move around easily.

Regular access to healthcare professionals facilitated early identification of other health concerns, helping to prevent avoidable illness and discomfort. There was strong advocacy for people’s health needs, including challenging unsafe care practices by external providers such as hospitals. A relative told us, “Staff were always quite quick to get [my family member] seen by the GP. They were very good at getting doctors and specialists.”

The provider monitored people’s care and treatment. However, the recording methods lacked detail, limiting their usefulness for oversight and continuous improvement. The provider was addressing this by introducing mandatory text fields for staff in people’s care records, which was a positive step. Despite this, goal setting remained generic and repetitive, offering limited guidance for consistent practice. The current system did not adequately capture people’s views, decision-making support, or feedback on progress. Planned improvements were being put in place but were not yet embedded.

The provider did not always tell people about their rights around consent. Where people had the mental capacity to do so, they were empowered to make day-to-day choices about their care such as what to wear or who to spend time with. Staff demonstrated a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) in community settings. However, mental capacity assessments lacked detail, particularly around how individuals were supported to understand the decisions being discussed. Key elements, such as questions asked, responses given, and representation were not consistently documented. While staff understood the importance of seeking consent, staff told us that not all were supportive of people making their own choices particularly in relation to food and how people spent their time, indicating a need for further development. While people had tenancy agreements in place they did not currently have care agreements making clear their rights to choose their care provider. The provider had drafted a new care agreement which addressed this point, but the agreement was not yet implemented.