South Street

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 50 (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 information included in their assessments and care plans was not always accurate.Assessments and care plans were in place, however these sometimes contained conflicting information and guidance for staff. For example, a person’s care records gave conflicting information on how staff should support them with their mobility and transfers. Staff were not clear on how this should be done and gave conflicting answers when we asked them about the persons care needs. We saw the person was transferred without the use of any equipment, but could not confirm if this was the right way to support the person. This meant improvements were needed to ensure assessments and care plans gave accurate guidance for staff to follow in order to provide effective care. However, key workers met with people to engage them in planning their care and support and identify what they wanted to achieve. People’s relatives told us they were aware of assessments and care plans being in place but had not been involved in producing these.

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 had an electronic system in place for assessment and care planning which was evidence based. The system was used to provide evidence-based assessments and plans which could be updated. However, we found this had not been maintained and many of the care plans and risk assessments were considerably overdue for review and update. This meant we could not be assured people were receiving the support they needed and the information and guidance for staff was up to date. Improvements were needed to maintain accurate information in the system and check people were receiving the care they needed.

The provider did not always work well across teams and services to support people. The provider had systems in place to seek input into people’s care plans where needed from other professionals. However, the advice was not consistently documented in people’s care records and this meant staff were not consistently able to follow the advice. However, there was a handover system in place which staff reviewed at the start of each shift to understand the care people had received.

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. The provider did not ensure staff were following the advice and guidance given to them by health professionals. For example, where a person had been assessed as requiring a specific diet to manage their risk of choking, we saw staff were not consistently following this advice. In another example, the advice from an occupational therapist had not been accurately documented in a person’s care plan. This meant staff were unclear on how to support the person effectively. Staff had some knowledge of people’s diagnosed health conditions and care plans were in place which gave them guidance in some cases; however, improvements were needed to ensure the advice from health professionals was consistently followed. However, relatives told us they were kept informed about people’s health needs. A relative said, “If there’s any feedback or anything the staff let me know. They always inform me of what’s going on. [Staff members name] is their keyworker and they will let me know.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. Staff worked with people to identify outcomes they wished to achieve. These were set into a care plan and goals identified. However, where people had specific needs, with their diet, mobility and skin integrity we found reviews were not always completed. Daily records were not reviewed and monitored to ensure people were receiving the care and support they needed. We saw a person’s care records included information which showed staff had not consistently followed the SALT guidance to meet their assessed needs and as care records were not effectively monitored this had not been identified and addressed.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Observations showed staff were not consistently seeking consent. We saw a staff member approach a person with an apron, place this around the person’s body without seeking consent or offering any explanation about what they were doing. This meant improvements were needed to embed consent into staff practice. However, people told us they were asked about their care and support before it was delivered. Staff were able to describe where people could consent to their care and how mental capacity assessments were in place with best interest decisions for areas where people lacked capacity to consent. Records of decisions were included in the electronic care planning system.