Holgate House

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 requires improvement. At this assessment 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.

This service scored 58 (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 give enough detail about people’s health, care, wellbeing and communication needs.While care plans were in place, t, improvements were needed to ensure there were no gaps and enough information to give a good well rounded view of the person’s care needs. The new manager had recognised this prior to the inspection and they were making improvements to care plans with an action plan in place with support of the provider.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.Health-related care planning was also inconsistent. Audits identified missing health action plans and gaps in constipation management, health screening support and positive behaviour support. Where people required support with their behavioural needs were identified, positive behaviours support plans and proactive strategies were often absent. This limited assurance that care was consistently evidence-based.

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 well as a team and also with visiting professionals. Staff understood people’s health and care needs well where they could reliably share people’s situation with confidence. Staff worked well together and other teams. Staff had a positive working relationship with visiting professionals so people had joined up consistent care. Staff knew people well and care plans and risk assessments were high quality which detailed the person’s wishes, preferences and information about their life. Staff were passionate about providing good quality care.

Improvements were needed to support people to manage their health and wellbeing to maximise their independence, choice and control. While staff supported people to live healthier lives and where possible, reduce their future needs for care and support.People were supported to attend appointments, and staff sought clinical advice promptly following incidents.Activity provision supported many people to stay socially active and engaged. People accessed the community and took part in positive interactions. However, records showed that for some people there were repeated periods of non-engagement without clear review or adaptation of support to improve wellbeing. The impact of activities on people’s health and independence was not consistently evaluated.

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 andconsistent, or that they met both clinical expectations and the expectations of people themselves.Although leaders had a clear intention to improve and were actively addressing shortfalls with monitoring and improving outcomes, the impact of actions taken was not yet consistent across the service. This limited assurance that outcomes were being systematically monitored and improved for all people.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.Staff demonstrated an understanding of people and involved them in day-to-day decisions however key records around consent were missing. The registered manager organised for these to be put in place in response to inspection feedback.