Archived: Optimum Supported Housing Limited

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 at the new registered address. This key question has been rated inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to person centred care and consent.

This service scored 25 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. The provider failed to ensure people needs were fully assessed. One person’s care plan detailed they had a cataract and needed staff support to attend check-ups. There was no other information regarding the person’s cataract, how this affected them on a daily basis, when their last checkup was or when their next appointment was. Assessments of care were not up to date and staff did not understand people’s current needs. One person’s care plan stated ‘[relative] said they have a history of diabetes’. There was no other information in the care plan regarding support that this person may need regarding diabetes.

People’s communication needs were not fully assessed, which meant the effectiveness of their care could not be maximised. One person’s care plan detailed they needed staff to talk in short sentences or British sign language. There was no other guidance in the persons care plan regarding the persons communication needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’s care and support was not always delivered in-line with best practice guidance. For example, NICE guidance around medicines administration was not followed by staff. The accessible information standard had not been considered by the provider. For example, one person’s care plan detailed they had as speech impairment, however there was very limited information for staff on how they should communicate with this person effectively.

People’s nutritional needs were not fully considered in their care plans. For example, one person’s care plan detailed ‘I do not need staff to prompt me to eat and drink but requires staff support to prepare healthy and balanced diets.’ However, no other information was detailed for staff including what food they did or didn’t like.

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. Staff did not have access to the information they need to appropriately assess, plan and deliver people’s care, treatment and support. For example, people’s support plans did not contain information that was accurate or reflective of people’s current needs. Whilst information in people’s care and support plans were poor, we saw occasions where staff did support people to access other health professionals, such as psychiatrists and the mental health team.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. People’s care plans did not document how they are encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing. Staff completed daily notes, but they contained very limited information and did not detail how they have supported people with their health and wellbeing. People’s care plans did not provide detailed guidance to staff around people’s oral health, particularly if there were concerns. For example, one person’s care plan detailed that they needed to spend a longer time brushing their teeth. There was no other information as to why this was the case and if they needed more regularly support from a dentist. However, daily notes for people did detail if they had supported people with their oral healthcare but with the lack of detailed guidance we are not assured staff were supporting them in a way that met their needs.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. The provider did not have systems in place to monitoring and review people’s outcomes. People’s care plans were not reflective of their current needs and risks assessments were not updated following changes in health conditions. For example, one person had seen their GP regarding constipation but the care plan and guidance for staff had not been implemented, neither had a bowel monitoring chart. Staff could not be sure that the person’s health may be deteriorating due to the lack of monitoring in place.

The provider failed to ensure that people’s capacity was assessed in line with the Mental Capacity Act 2005. There was very limited information in people’s care plans around their capacity. One person’s care plan detailed they ‘lacked capacity to make complex decisions. There was no other information around what type of decisions these were and what happens when complex decisions needed to be made on their behalf.

The provider had failed to ensure capacity assessments that were in place were accurate and appropriate. One person had a capacity assessment regarding accessing the community and that they needed support of 1 staff member. However, the person needed the support of 2 staff member at all times and this was a greater restriction placed upon that person which was not included in the discussion. They also had a capacity assessment regarding their diet but it was not clear what why this capacity assessment was required and what restriction was in place.

We observed at 2 of the locations that the front doors were locked and only staff had access to the key. There was no information in people’s care plans regarding the front door being locked or whether people lacked the capacity and whether the restriction placed on them was in their best interest.