Catchpole Court

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• 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 62 (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 had not always checked people’s care and support was meeting their needs and preferences effectively. People’s care needs were assessed prior to them receiving support. However, this information was not always adequately personalised and detailed. People’s care documentation had not always been monitored to ensure it remained up to date and accurately reflected their current needs.
The provider used clinical assessment tools to monitor people’s risk of malnutrition and developing pressure wounds. Complex health needs were identified. However, not everyone had a care plan specific to their health care needs including diabetes, Parkinson’s and end of life needs, wishes and preferences.
Not everyone admitted for respite care had a plan of care and risk management guidance in place. We noted one person had been staying at the service for 10 days prior to our visit and did not have a care plan in place despite their multiple health conditions. This meant there was a risk staff may not have the correct information about how to support people safely and appropriately.
 

Best practice guidance was used to ensure consistency. For example, nationally recognised tools such as the multi universal screening tool (MUST), were used to assess people's nutritional risk.
People’s nutritional needs were assessed and monitored. People were given a choice of freshly prepared meals which were nutritionally balanced. Meals were fortified when needed to help increase people’s weight. Changes in weight were monitored, and the staff had made referrals to specialist healthcare professionals when required.
Staff carried out Waterlow assessments which determined a person’s risk of developing skin damage, completed oral health checks and undertook a falls risk assessment on each person.
 

The staff had effective systems for communicating with one another. They had daily handover meetings where they updated each other on any changes for people. The management team also met daily to discuss the service.
Staff communicated well with other professionals. People were supported by staff that worked well together and with other services. This helped to ensure a joined up, consistent approach to delivering safe and effective care to people in line with their individual needs. One person told us, “I can be seen by the GP when I need to, and I can see the chiropodist to sort my feet.”
The registered manager told us the service enjoyed a good relationship with the local GP practice, one of whom visited each week and sooner if needed.
 

Where people were in pain or their health was deteriorating, staff engaged the GP or another appropriate health professionals.
People spoke positively about the care they received, including with eating and drinking. People and relatives told us people had plenty of food and drink, and their nutritional needs were met. One person said, “The food is pretty good, I have no complaints.” Another said, “There are a lot of people to please and they won’t get it right all of the time, but I am happy with the food provided. If I don’t like something they will offer me something else”.
 

Processes needed improvement to ensure people's care and treatment was monitored effectively. Further work was needed to ensure there was a system of management oversight as the care planning system did not alert staff when safety and wellbeing checks were needed and when these had not been carried out, such us when repositioning was required to prevent the risk of pressure wounds, catheter bag changes were needed and when there was a decrease in fluid intake to alert staff to offer extra sources of fluid to maintain their health and wellbeing. This increased the risk that people’s needs would not be met.

Weekly GP visits to the home evidenced appropriate reviews and referrals for people who needed them, such as those experiencing weight loss. When people’s weight dropped below expected ranges, people were referred for specialist advice and support.
 

Not everyone’s mental capacity had been assessed. The provider had not consistently sought and recorded people’s legal consent to care and treatment.
Records showed mental capacity assessments and best interest decisions were not always in place where people had restrictions placed on them to ensure the Mental Capacity Act had been applied. For example, the use of bed rails, which can restrict the movement of the person and where medicines were administered covertly.

We found gaps in people’s care plans which meant staff had not been provided with the guidance needed. Where mental capacity assessments were in place, information was brief and did not include all detailed information about how the service had explored all options available to involve the person in the decision and best interests process was followed.

Staff told us they would respect people’s right to refuse support but understood the need to report any consistent refusals recognising they may need to act in people’s best interests. One staff member told us, “If people refuse our help we go away and try again later, maybe with a different member of staff. I would also speak to the manager if things persisted. “Staff also told us they were not aware of any formal process for referring any potential deprivation of liberty guidance.