244 Wootton Road

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 inspection we rated this key question Requires Improvement. At this inspection the rating has remained Requires Improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to consent to care and treatment.

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.

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 and wellbeing needs with them.

Care plans were in place for people; however, the care plans viewed on-site had not always been updated to include people’s current needs. The service provided care plans which had been updated; however, these had not been kept on-site.

The service was unable to provide evidence that relatives had been invited to care review meetings before the inspection process had begun, evidence was provided that a relative had been invited to a care plan review during the inspection process.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The service used clinical tools such as weight logs, food and fluid charts and behavioural monitoring charts although we found concerns regarding the monitoring of fluid intake records. One person required a fluid intake record to be completed, staff were completing this, however, on at least 2 occasions they had not met their daily fluid intake target. Staff spoken with were unsure of who reviewed fluid intake forms and the frequency they were reviewed.

We found other records had been completed to a higher standard.

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.

Staff worked collaboratively with health and social care professionals. People had detailed hospital passports in place which provided important information in the event they needed to attend hospital in an emergency.

We found that referrals had been made to different health professionals such as the Speech and Language Therapists (SALT).

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

We observed that people were offered a range of choices for their meals and that staff supported and encouraged people with their decisions. People were encouraged to access the community.

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.

While monitoring records were in place, we found that there were some inconsistencies with the reviewing of the records, which had not been identified by the service. Meaning that opportunities to improve care and treatment could have been missed.

Despite this, the service worked well with healthcare professionals in regard to people’s behaviours, physical health needs and mental health concerns.

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

We found that there was a lack of governance oversight and that consent to care and treatment had not been lawfully obtained in accordance with the Mental Capacity Act 2005.

Where required, people had Deprivation of Liberty Safeguards (Dols) in place or applied for. However, we found that 2 people’s approved Dols paperwork recorded the wrong address, this had not been identified by the service. One person no longer had a next of kin or someone able to support them with decision making outside of the service, and an Independent Mental Capacity Advocate (IMCA) had not been identified as needed or requested by the service. Mental Capacity Assessments were not always in place; however, those that were in place were detailed and had been completed to a high standard.

We found that consent forms were only in place for photography and vaccinations, however, these did not have corresponding mental capacity assessments.