Prominence Care Group

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 provider was in breach of legal regulations in relation to consent to care.

This service scored 46 (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.

We were not assured the provider had procedures in place to assess people’s needs effectively. We asked to see a person’s initial assessment and the registered manager provided a ‘proposed support’ document; however, this did not cover all aspects of the person’s needs.

Whilst the person had a support plan in place, which included other aspects of their care needs, this did not provide individualised information about all aspect of their care needs, including the impact of any health conditions. Whilst their relative had been involved in day-to-day discussions with staff about the person’s care needs, they told us they had not been involved with the development of their relative’s support plans.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.We received feedback which indicated a person’s needs were not being effectively met. The provider had a system in place whereby staff could access information about people’s needs via electronic care records. However, support plans did not include all the required information about a person’s needs and staff were not aware of all required actions. For example, one person required a fortified diet and to be weighted weekly. Staff told us they supported the person to make meal choices but were unaware of the need to weigh the person and their care plan did not include the information about a fortified diet.

It was important for a person to go out and attend a regular group in the community, however, the provider had not ensured staff were effectively trained and supported to facilitate this safely. Where a person could become distressed and display behaviours of concern, there were no detailed plans or strategies in place to guide staff about supporting the person effectively, such as with de-escalation techniques. Some staff felt they had information to support people and managers were available for guidance, however, not all staff felt they had been fully trained.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Feedback from a relative and professionals indicated there were concerns relating to effective communication and the provision of information from the service. However, the registered manager told us they worked with GP’s, social workers and other health professionals to support people effectively. We saw records where staff had liaised with professionals.

The registered manager and senior staff covered an on-call rota to support staff out of hours.

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.

The registered manager shared examples where staff had supported a person with aspects of their health care needs, such as attending hospital appointments and advocating for them. Staff made referrals to health professionals such as occupational therapy, where required. However, there was limited information within a person’s support plan about the support they needed with all aspects of their health needs. For example, there was no information about their mental health needs or how their dentistry needs should be met.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or they met both clinical expectations and the expectations of people themselves.

The provider had systems in place to review people’s care needs. However, where support plans had been reviewed by staff, records did not demonstrate relevant people had been involved. A relative told us whilst they had regular contact with staff, they had not been routinely included in any review meetings. Following our feedback, the provider told us they planned to improve their approach to engage with people, to ensure their wishes were at the centre of their care.

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

The registered manager did not work in line with the Mental Capacity Act 2005 (MCA). People’s ability to make specific decisions relating to their care and treatment was not effectively assessed. We found some restrictive practices had been put in place for one person, due to concerns about potential risks. Records stated staff should monitor a person’s movements around the home closely and had stopped supporting them to go out. However, there were no records about whether the person had consented to this or whether best interest decisions had been made. Whilst the registered manager told us they liaised with the local authority about any restrictions, we were not assured they were fully aware of their responsibilities in relation to the MCA, placing people at risk of being deprived of their legal rights. We confirmed the local authority was working with the person in relation to these concerns.

Staff told us they had received training in relation to the MCA. Where people were able to consent, staff told us they understood the importance of this. A staff member said, “We don’t force anything on them, we get their consent.”