Provence House

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 people’s outcomes were generally good, and people’s feedback confirmed this.

This service scored 63 (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 health, care, wellbeing and communication needs with them.

Staff assessed people’s needs when they moved into the service and gathered relevant information from families and professionals. Care plans contained detailed information about health conditions, routines and risks, and people were included in reviews where possible. One relative told us, “I know the care plan in detail, I am very involved.” However, assessment information was not always updated.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider aimed to follow national guidance and recognised frameworks, and staff understood how to use tools such as those for skin integrity or dietary assessments. People told us they were well supported with meals and to stay hydrated. However, not all evidence‑based practice translated into day‑to‑day care. For example, the dining experience was inconsistent, and staff were not always confident or clear whether meals were appropriate for people who required different textured diets. Staff sometimes sought advice from colleagues, but systems were not robust enough to provide consistent assurance about the suitability of meals. Staff did not always have access to complete documentation, such as DoLS authorisations or Lasting Power of Attorney information. This meant staff could not always rely on care plans to guide practice.

The provider worked across teams and services to support people. However, poor management oversight meant internal communication was inconsistent.

Staff worked well with external professionals, including GPs, district nurses and therapists, who told us staff were well prepared for clinical rounds. The service used electronic systems to share updates, and people benefited from timely referrals. Staff described supportive working relationships, and we observed kind interactions during care and mealtimes. However, important information about people’s routines, dietary needs and recent events was not always passed on between shifts. One relative explained agreements about a preferred food option made during one shift were not followed by the next. Staff also lacked shared understanding about why some people were not hungry at lunchtime or why certain restrictions were in place. Efficient handovers were not in place and often lacked relevant detail. This meant people had missed opportunities, such as outings, because staff did not coordinate preparation in time. Following feedback, the provider has re-commenced short daily meetings meaning staff now have a good awareness of their tasks each day.

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.

People were supported to maintain and improve their health. Staff monitored hydration, bowel health, weight and mobility, and took action where concerns were identified. People told us they had access to GPs, chiropodists and other visiting professionals. Staff encouraged people to make healthy choices, such as offering drinks regularly and promoting activity. One person said, “They (staff) are all really kind and will do anything for me.”

While we found some care plans contained conflicting information, the sections about medical conditions, symptoms and how staff should respond contained good quality information.Staff recognised when people needed support with personal care or changes in wellbeing, and they encouraged mobility improvements, which had positive outcomes for some individuals.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service had introduced new systems to monitor outcomes, such as fluid‑intake email alerts, daily walk‑rounds and audit tools. Managers reviewed emerging themes and created tasks for staff to follow up. Some people showed improved mobility or better hydration after interventions. Relatives confirmed staff noticed changes in health and acted on them promptly. One said, “If [Name] is upset, they call me. It does not take long for me to get here.”

The provider demonstrated a growing focus on reviewing care and identifying improvements. However, whilst staff monitored areas such as falls, skin integrity and nutrition and hydration, a lack of consistency in these meant this aspect was yet to be fully embedded.

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

Staff supported people to make decisions wherever possible and used appropriate language to explain options. Relatives confirmed they were involved in decisions about care, and we observed staff seeking permission before providing support. People who could give consent were supported to express preferences, such as food choices or daily routines.

However, consent records were inconsistent and there was a lack of clarity about where this information was stored. Several people lacked completed best‑interest decisions, including for bed rails, sensor mats and restrictions. DoLS documentation was incomplete or out of date in several cases, and conditions were not always reflected in care plans. It was not always clear from the electronic care system whether information about who held lasting power of attorney was available, and paperwork was not easy to access. While staff demonstrated caring and respectful practice, the documentation and managerial oversight required to ensure lawful consent was not reliably in place.