Ideal Care Services - Kent

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 inadequate.

This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to person centred care.

This service scored 38 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

People’s needs were not effectively assessed. For example, one person’s care plan documented a ceiling hoist should be used for transferring the person. However, there was no guidance for staff on how to do this safely, including what type of hoist sling should be used for transfers.

People’s skin integrity was not robustly assessed and managed. People who were identified as needing repositing did not have clear guidance in place for staff to follow. Daily notes recorded that people were repositioned, however there were no other details including time stamps to ensure this was carried out in the time frames needed to reduce the risk of pressure ulcers.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards. People’s care and support was not always delivered in-line with best practice guidance. For example, National Institute for Health and CareExcellence (NICE) guidance around medicines administration was not followed by staff in relation to medicines that were prescribed as and when needed. NICE guidance details robust protocols should be implemented to ensure staff follow the correct guidance on when to administer the ‘as required’ medicine to monitor it’s effectiveness.

Best practice clinical assessment tools had not been used to help assess people’s needs and formulate care plans. Assessment tools had not been considered to help implemented a robust skin integrity care plan and risk assessment.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Staff did not have access to up to date information they needed to appropriately assess, plan and deliver people’s care, treatment and support. For example, people’s care and support plans lacked important information about their health risks to ensure they could support people safely and in line with their preferences.

However, when a referral was needed to a specialist health care team, these referrals were made. This including referrals made to the occupational therapy team. Occupational therapy teams support a person’s independence in daily life.

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.

Care plans for people did not contain any information about what people were able to do for themselves, to encourage them to stay as healthy as possible. Care plans did not provide sufficient information about how staff should support people to maintain and promote their health and wellbeing. They did not clearly identify the activities, routines and interventions that could help people stay physically and emotionally well, such as appropriate physical activity, spending time outdoors, maintaining good sleep routines and engaging in meaningful social activities.

Whilst care plans did not contain this information, some people’s relative told us their loved ones were supported by staff to spend time outdoors and take part in activities.

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.

People’s nutrition and hydration needs were not always monitored when the need had been identified. One person’s care plan detailed they required their hydration intake to be monitored to ensure they are drinking enough. However, there was no evidence the person’s fluid intake was being monitored. Daily notes did not consistently detail what drinks were offered, how much was consumed or a total amount for the day. The staff could not effectively monitor that the person was maintaining adequate hydration which placed them at greater risk of harm.

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

People’s care and support plans lacked detail in relation to consent. Whilst consent forms were present, care plans did not detail whether people’s capacity had been assessed and what decisions they were able to make for themselves or who had been appointed to make decisions on their behalf. There was a risk that people’s rights, wishes and preferences were not consistently understood or respected, which could result in people not being supported in accordance with their individual needs and legal rights.

However, people’s daily notes detailed when staff were asking people for their consent to carry out tasks such as personal care and administering medicines.