Cross Heath Grove

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 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 46 (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, health and wellbeing needs were fully assessed, reviewed and reflected in detailed care plans. We found examples where important risks were not fully assessed or recorded. For example, one person was described by managers as requiring 1:1 support due to choking risks, but these risks were not clearly reflected in their care plans and risk assessments. Another person with complex health needs had issues with their skin integrity, but there was no skin integrity risk assessment or care plan in place at the time of our assessment. These gaps increased the risk of people not receiving consistent and appropriate support. The provider reviewed these people’s care plans and risk assessments following our feedback.

The provider did not always make sure people received care and treatment that reflected current evidence, best practice guidance and their assessed needs. We found several concerns regarding medicines management. Records did not consistently demonstrate that delegated healthcare tasks were managed in line with best practice guidance or that professional oversight arrangements were in place. The provider told us they were reviewing their processes to strengthen governance and oversight in this area.

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.

The provider worked with relatives and healthcare professionals to support people’s needs, but collaboration was not always effective in ensuring important information was up to date and acted upon. We saw examples of staff working positively with relatives and external professionals to support people. However, we also found circumstances where health concerns had not been escalated effectively or where information about people’s needs was not sufficiently updated before respite stays. This created a risk that staff may not always have access to the most accurate information when planning care and treatment.

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.

We found examples where staff worked well with other healthcare professionals and relatives, to meet the needs of people. But we also found examples where improvements were required in escalating health concerns to people and ensuring all relevant information about people needs was up to date before each visit. We also found examples where relevant information had not been updated before people attended the service, increasing the risk of inconsistent support.

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.

We found limited evidence that people’s goals, progress or outcomes were routinely reviewed and updated.

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

Systems and processes relating to the Mental Capacity Act 2005 were not consistently implemented. Although mental capacity assessments were in place for some people, the registered manager had already identified that these were not always decision specific in line with requirements, and further development was needed, but limited progress had been made.

During our assessment, we found staff were using sound and image monitoring devices at night. Records did not demonstrate how decisions to use these restrictions had been made in people’s best interests, whether less restrictive alternatives had been considered, or why the arrangements remained proportionate. These concerns meant the provider could not demonstrate that restrictions on people’s liberty had been lawfully considered and authorised in line with the Mental Capacity Act. Following our feedback, the provider suspended the use of the monitoring devices while carrying out further assessments and reviews.