Hardwick Dene

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.

At our last assessment we rated this key question good. At this assessment the rating has changed to 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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care,wellbeingand communication needswith them.

Care records did not always accurately reflect people's current needs. We found examples where information within care plans was inconsistent with other care records and did not always reflect information known to staff.Care plans were not always updated to reflect changes in people's needs and circumstances. This reduced assurance that assessments were regularly reviewed and accurately reflectedpeople'schanging 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 did not always receive care and support in line with recognised good practice. We found examples where care plans for long-term health conditions, including epilepsy and chronic obstructive pulmonary disease (COPD), did not provide staff with sufficient guidance on monitoring people's health, recognising deterioration or responding appropriately to changes in their condition.

This reduced assurance that people's care and treatment were consistently planned and delivered in line with current evidence-based practice.

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 had access to a range of healthcare professionals including GPs, district nurses and specialist services. Staff were able to describe how they worked alongside external professionals to support people's health and wellbeing.

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.

People were not always supported to manage their health and wellbeing effectively. Records relating to people's physical health, including wound care, skin integrity and long-term health conditions, were not always consistently monitored or reviewed. Care records did not always demonstrate that changes in people's health had been recognised promptly or that appropriate action had been taken.

This reduced assurance that people were consistently supported to achieve positive health outcomes and maintain their health and wellbeing.

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 that they met both clinical expectations and the expectations of people themselves.

Systems used to monitor people's care and treatment were not always effective in evaluating whether care achieved positive outcomes. We found examples where records used to monitor wound care and skin integrity were incomplete or did not clearly demonstrate ongoing review and evaluation.

Although leaders introduced additional monitoring tools during the inspection, these had not yet become embedded in practice. This reduced assurance that monitoring information was consistently used to evaluate care and improve outcomes for people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff demonstrated an understanding of consent and the principles of the Mental Capacity Act 2005. People were supported to make decisions about their day-to-day care and support wherever possible.

Records showed mental capacity assessments and deprivation of liberty safeguards documentation were in place where required. People’s rights were generally understood and respected when decisions about their care and treatment were made.