Carisbrooke 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 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, wellbeing and communication needs with them.

People we spoke with told us they were happy with the support provided by staff and felt staff knew them well. Staff demonstrated a good understanding of how to communicate with people effectively and used approaches that helped individuals express their needs and wishes.

However, care plans were not always reflective of people’s current needs. Although reviews were completed regularly, there was no evidence the person or those important to them had been consulted as part of the review process, nor any recorded rationale when this had not happened. This meant care planning was not consistently person‑centred or inclusive, and opportunities to involve people meaningfully in decisions about their care were missed.

The provider took action, reviewed and updated care plans and liaised with relevant professionals to ensure that information held in care plans was relevant and supportive.

The provider did not always plan or deliver people’s care and treatment in partnership with them, or in a way that reflected what was important and mattered to the individual. While staff understood people well and aimed to provide supportive care, this was not consistently supported by accurate or comprehensive documentation.

Records did not always demonstrate meaningful reviews or show that people had been involved in decision‑making about their care. Care plans were not always updated to reflect key information, including individual support needs for specific health conditions such as skin management. This limited the provider’s ability to ensure care was effective, evidence‑based, and person‑centred.

Some care plans contained inaccuracies that had not been identified or corrected. These errors had the potential to affect people’s outcomes and indicated that auditing and review systems were not always effective in maintaining high‑quality, reliable care records.

The provider used positive behaviour support (PBS), which is a recognised proactive framework for supporting people who may find it difficult to communicate their needs. Staff had completed relevant training and understood how to promote a positive and safe environment. However, PBS plans reviewed lacked sufficient detail on how to keep the person safe, or when certain support strategies should be used in practice. We raised this with the management team, who took action to review and update the care plan and provided evidence of the improvements made.

People were supported to cook meals and develop independence around food preparation. However, the meals chosen did not always support a healthy, balanced diet, limiting the provider’s ability to meet people’s nutritional needs in line with best practice guidance.

People were not always supported to have regular health checks. In one case we reviewed, care records did not show when the person had last attended the optician or when their next appointment was due. Although there were records of visits to the GP, it was not clear when the person had last received their annual health check in line with (National Institute of Health and Care Excellence) NICE guidance. This meant opportunities to support people to maintain their long‑term health and wellbeing were missed.

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.

The service worked with a wide range of health and care professionals including community nurses and education settings. We received feedback from professionals who told us, “The quality of joint working between the residential home and the school is good; School can discuss matters directly with managers, including challenge. Carisbrooke House implemented a robust transition plan to support the young person’s transition into their service. Carisbrooke House have developed a positive relationship with the young person. Carisbrooke House’s staff are approachable, have a nice demeanour and are professional.”

Where guidance had been provided by professionals, we saw it had been recorded in daily notes but not always reflected in the care plans.

The provider did not always support people to manage their health and wellbeing in a way that enabled them to maximise their independence, choice and control. Staff did not consistently help people to live healthier lives or, where possible, reduce their future need for care and support.

Although health care plans were in place, they lacked sufficient detail and did not demonstrate how people were being supported to access routine health services. This meant the provider had not ensured health checks were completed in line with NICE guidance for people living with a learning disability. NICE recommends annual health checks as an important way to identify emerging health concerns early and promote actions such as vaccinations, blood tests, breast and testicular screening, dental reviews, and vision and hearing assessments.

Records showed that some people had not received key health checks, including dental, vision or hearing assessments. This placed people at risk of health issues not being identified at an early stage and reduced opportunities for them to maintain or improve their long‑term health.

People did see their GP when they showed signs of being unwell, and staff made referrals to specialist services where required. However, the lack of proactive and preventative health support meant people were not consistently enabled to live healthier lives or benefit from early intervention.

The provider did not always routinely monitor people’s care and treatment to drive continuous improvement. Systems were not consistently effective in ensuring outcomes were positive, reliable or aligned with both clinical expectations and what mattered to people themselves.

People had goals in place intended to support a healthier lifestyle and promote independence. However, these goals were not clearly measurable, and there was no clear process to show how progress would be reviewed or evaluated. This limited the provider’s ability to track whether people achieved the outcomes important to them or identify when additional support may be needed.

Care plans lacked detail for specific healthcare needs and did not provide clear, up‑to‑date guidance on how staff should support people with these needs. This created a risk that changes in a person’s health might not be recognised or responded to adequately. We raised this with the manager during the assessment, and they took prompt action and contacted relevant professionals and updated the care plans to reflect the required care, support strategies, and who to contact if concerns arose. This improvement will help staff respond more effectively and consistently if people’s conditions change.

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

We observed staff supporting people in ways that met their needs. Mental capacity assessments were in place and where required were supported by a best interest decision.

Staff had received training regarding mental capacity and demonstrated their understanding of this.

Staff were aware of seeking people’s consent where they had capacity or acted in their best interests if they did not. One person told us, “I always ask for permission before providing personal care or support with meals. Even if the person has limited capacity, I still explain what I am about to do in a way they can understand. I seek verbal or non-verbal consent, such as a nod, eye contact or communication book... I respect their right to refuse and report any concerns appropriately. I never assume consent just because it is part of their care plan. I still check every time.”