Mentaur Community Support Limited

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 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, wellbeing and communication needs with them.

Reviews were taking place but were not completed with the person. This was discussed and the registered manager (RM) who confirmed reviews would now be carried out with the person and

relatives as appropriate. Care plans did not include goals, longer term aspirations and outcomes, such as holidays and independent living, during this assessment the management team had started to review all care plans, and we were shown a care plan which now included the person’s goals and outcomes. Care notes required further information, spot checks had already identified this, and the RM agreed to increase spot checks until improvements were made.

Staff knew people well and could recognize changes in presentation.

Assistive technology was in place where appropriate and people's needs were assessed before they started using the service.

We received mixed views regarding being involved in people's care planning. One relative told us, Had information when (person) first went in. Not really had any information." Another said," I

have a copy of (person’s) care plan.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Positive support plans were in place and provided staff with clear guidance on how to support people safely and consistently.

Staff had received training in supporting people with a learning disability and autistic people, and most had completed Oliver McGowan mandatory training, with only newer staff to complete this.

People's nutrition and hydration needs were understood by staff, and we saw that these needs were being met appropriately.

Relatives felt people were supported well. One relative told us, "They changed (person’s) diet when I asked.”

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.

Care plans required further detail to be clear and contemporaneous. They did not contain enough information for partners or other professionals to gain an accurate understanding of each person, including equipment used, preferences for support staff, medicines, or required 1:1 support hours.

Hospital passports were in place but required additional information such as mental capacity and DNACPR status. We saw evidence of multidisciplinary working, including communication with GP's and social workers, and MDT meetings took place.

Relatives told us staff and services worked well together. One relative told us,"(staff member) informs me.” Another said “It works. I get phone calls. (Person) will let me know. I can contact the manager, and they will let me know everything I need to.”

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.

People received regular input from health professionals, including chiropodists, opticians and diabetic review teams, and this support was documented appropriately.

Additional support was needed in relation to dental care. Although we were told attempts had been made to access dental services, and we could see some people had refused, there was limited recorded evidence of proactive planning to ensure ongoing dental oversight.

People expressed interest in activities such as swimming and attending the gym, but we saw no evidence of plans or support in place to help people pursue this interest and achieve healthier lifestyles.

People and their relatives told us they felt they were supported to live healthier lifestyles. One relative told us, “They do encourage (person) to be more mobile.” Another said, “We all work

together.”

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 relatives were generally happy with the support their family member received. One person told us, “Yes, always asked to go out, (relative)chooses to go bowling and cinema when in the mood." However, there was a lack of effective systems and processes for monitoring and improving outcomes for people. Goals and aspirations were not recorded, and there were no plans in place as to how people would achieve or work towards their goals. Key worker review meetings took place; however, this was not acted on, there were no progression plans in place.

There was a lack of focus on supporting people to pursue activities they were interested in, to support their independence and quality of life.

This meant outcomes for people may not be as positive as they could be or meet all expectations

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

There was no clear evidence that people were consistently involved in decisions about their care.

Nobody currently had a DNACPR in place: however, this was not clearly documented, and not all staff were aware whether DNACPR decisions applied to the people they were supporting.

Mental Capacity Act (MCA) processes required improvement. Assessments did not evidence the questions asked, the person's responses, or that the questions had been revisited.

We identified a person who we were told had no capacity, had no MCA in place, we were told this was due to having a Lasting Power of Attorney (LPOA) in place. However this had not been verified. Following discussion, the LPOA was obtained and mental capacity assessments were completed.

Consent to care and financial arrangements were recorded where appropriate and staff gave good examples of how they gained people's consent.