CSM Care Services LTD

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 good. This meant people’s outcomes were consistently 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 did not always make sure people's health, care, wellbeing and communication needs were comprehensively assessed and reflected in their care documentation. The provider completed initial assessments before people received care and involved people and those important to them when planning their support. However, some care plans and risk assessments did not contain sufficiently complete or consistent information about people's health conditions, risks and support needs. The provider reviewed and updated care documentation as part of its ongoing quality assurance processes and made further amendments during the assessment period. However, some of these changes were recent and further consistency was required to ensure records remained complete and reflected people's changing needs.

The provider did not always ensure people’s care was planned and delivered in accordance with sufficiently clear, evidence-based guidance. Staff received training and demonstrated knowledge of people’s needs, including how to recognise and escalate changes in health. However, records reviewed during the assessment did not always contain sufficiently clear guidance about the management of specific health conditions, including pressure damage, catheter care and diabetes. Care plans were reviewed and updated during the assessment period, and revised records contained additional information. However, inconsistencies remained within some records and guidance was not always sufficiently detailed to ensure information about people’s health conditions, risks and support needs was reflected consistently across care documentation.

The provider worked well across teams and services to support people. Staff and leaders communicated with healthcare professionals, commissioners, safeguarding teams and other agencies involved in people’s care. Staff described contacting managers and relevant professionals when people’s needs changed, and records included examples of liaison with district nurses, occupational therapists and emergency services. An external professional described the provider as responsive, easy to engage with and willing to investigate concerns and provide information about the outcome.

The provider supported people to manage their health and wellbeing and access healthcare services when required. Staff understood that changes in people’s health should be reported and were able to describe signs of urinary tract infection, catheter concerns and stroke. Records and staff feedback included examples of contacting district nurses, GPs and emergency services, and of adapting visits to support people to attend healthcare appointments. Leaders had also identified additional practical training to further strengthen staff knowledge of recognising and responding to deterioration.

The provider did not always effectively monitor people’s care and treatment to ensure their outcomes were consistently reviewed and improved. Systems included audits, care-plan reviews, electronic monitoring, quality meetings, spot checks and feedback from people and relatives. The provider demonstrated an example where concerns raised about one person’s care resulted in agreed actions, regular contact with the family, service reviews and documented improvements. However, other records did not always provide a clear audit trail showing how changes in people’s health, professional advice and actions taken had been followed through and reviewed. Local monitoring arrangements were in place and continued to be developed, but greater consistency was required to demonstrate that identified concerns resulted in updated guidance and improved outcomes across the service.

The provider informed people about their rights and respected consent when delivering care and support. Staff had received training in the Mental Capacity Act and understood that people had the right to refuse care or medicines. They described encouraging people, explaining concerns and seeking further advice where necessary without forcing care or treatment. Leaders said people currently receiving support were able to consent to their care, and records contained information about people’s capacity and consent.