In Caring Hands Wells

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 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 consent for 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 made sure people’s care and treatment was effective by assessing and reviewing their needs with them.

People had personalised care plans in place, although we found some information needed clarification and updates. Relatives were involved in care plan reviews and had opportunities to provide feedback. One relative told us, "I can feedback anytime really." Staff worked with people’s relatives and told us, "It's really important to do handovers with family." Staff were knowledgeable about people’s needs and routines.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Unclear medicines guidance, a lack of monitoring of specific risks, missing mental capacity assessments and risk assessments meant that the service was not always acting in line with best practice. This increased risks of harm to people. Whilst the service did work with external professionals, reviews were not always requested in a timely manner.

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. People were supported by regular staff, promoting continuity of care. New staff had opportunities to shadow experienced staff before lone working, this ensured staff could meet people’s needs. There was evidence that external professionals were involved and provided information to the service.

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.

One relative told us that physical movement was helping a health condition from deteriorating, staff provided this support. Staff supported people to access activities such as swimming. One person was continuously encouraged to walk instead of using a wheelchair, this promoted independence and their physical wellbeing.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. We found that where risks had been identified, effective monitoring was not in place, for example for people’s hydration and bowel management. This meant concerns were not always appropriately escalated. Concerns with medicines had not been identified by the provider enabling them to be addressed at an earlier stage, for example when medicines were not administered as prescribed. This demonstrated a lack of effective oversight and timely actions taken, therefore further improvements were required to improve outcomes for people.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. The provider did not adhere to the Mental Capacity Act 2005, which provides a legal framework for making decisions on behalf of people aged 16 or over who may lack the mental capacity to do so for themselves. We found that there was a lack of documentation in place. The registered manager did not carry out decision specific mental capacity assessments, for example for the use of a lap belt and chest harness, video monitoring and support with personal care. Best interest decisions involving appropriate representatives were not in place. This meant the registered manager did not act in line with best practice and people’s rights may not have been protected when decisions were made on their behalf.