Cleadon Court

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 was the first inspection for this 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 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff had not always made sure people’s care and treatment were effective because they had not always ensured people were admitted whose needs they could meet. Staff had not ensured people’s health, care, wellbeing and communication needs were accurately and fully recorded. Staff used an electronic care record system but were not fully familiar with it, so a lot of information was either not recorded or could not be found. The system did not cover all the areas staff needed to assess for the client group such as how an acquired brain injury impacted them, use of physical interventions and managing bereavement. A staff member said, “I was not working at Cleadon Court when the support plans were devised. I have reviewed care plans and when reviewing them it is difficult to find relevant information on how to the people we support. However, the people we support have been involved in developing risk management strategies.” The new management team were taking steps to improve the care records.

The staff team planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, the service had been accepting people with complex needs, which staff had not been trained to meet. They had not been providing this type of support in line with legislation and current evidence-based good practice and standards. The provider had recognised the need to improve the processes around determining whether peoples’ needs could be met and created an admission panel of experts who reviewed each proposed placement. They had strengthened the panel by employing a mental health nurse to work alongside the other professionals to look requests for placements.

Staff worked well across teams and services to support people. They shared information about people’s needs when they moved between different services, so people only needed to tell their story once. However, professionals reported peoples’ care and support had been affected by staff having unclear guidance, them inconsistently implementing specialist advice and the challenges staff faced in managing high‑risk situations safely. A professional said, “Key workers appointed to patients seem to work well, but they are not always on duty and there doesn't seem to be alternative key workers. The high turnover of staff leading to inconsistencies therefore staff don't seem to know what is happening with the patients on a week-on-week basis. The instability has led to it being difficult to get carryover of care for therapy and assurance that exercises are being carried out. Onward referral appointment follow-ups seem to be poorly managed with therapy staff having to remind staff to chase up these appointments.” The new management had been made aware of these issues and were taking steps to address them.

Staff aimed to support people to manage their health and wellbeing to maximise their independence, choice and control. Staff assisted people to live healthier lives and, where possible, reduce their future needs for care and support. At times this had been difficult as they were asked to support people with complex needs they were not trained to meet so identifying indicators of risks to people’s health was more difficult. The new management team were reviewing the aims of the service and ensuring staff could meet the needs of people who were admitted. Staff liaised with external health and social care professionals to ensure people received consistent care and support. Staff ensured people’s health needs were monitored and they received a nutritious diet. Staff monitored people’s health and made sure they ate and drank well and were not showing signs of ill-health.

The new staff team monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and they met both people’s expectations. People were encouraged to attend health appointments and access services such as GPs and other professionals. Staff supported people with daily living activities and prompted healthier choices, where appropriate, while respecting people’s preferences and independence.

Staff told people about their rights around consent and respected these when delivering person-centred care and treatment. People made their own choices and decisions on a day-to-day basis about what they did, what they ate and how they filled their time. Staff had received training around the requirements of the Mental Capacity Act and associated codes of practice. They had completed capacity assessments and ‘best interests’ decisions but could not find them on the electronic care record system. The regional manager was able to show us the documents. However, staff were not always considering whether a capacity assessment and ‘best interest’ decisions were needed. The management team immediately took action to ensure the documents were improved.