Gogomadu Cares

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.

The service was in breach of legal regulation in relation to safe 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, wellbeing and communication needs with them.

We found that care plans demonstrated an over-reliance on staff interpretation and had been developed primarily as responses to a series of questions, rather than being truly person-centred.

Care planning documentation did not adequately address key areas of risk. For example, care plans did not clearly outline the actions staff should take to reduce identified risks in relation to constipation, mobility, long-term antibiotic use and communication.

This meant staff may not have had the information they needed to respond appropriately to changes in the person’s condition.

These concerns demonstrated that care planning processes were not always effective in ensuring people’s needs were fully assessed, accurately recorded, and safely managed.

The provider did not always plan and deliver people’s care and treatment with them in line with current evidence-based good practice and standards.

We found limited evidence that recognised clinical tools were used to assess and monitor risks. For example, for a person at increased risk of pressure ulcer development, there was no evidence that a recognised assessment tool, such as a Waterlow assessment, had been completed or used to evaluate current risk levels.

We also identified limited evidence that wider best practice guidance, such as National Institute for Health and Care Excellence (NICE) guidance, had been consistently considered or applied in care planning and delivery.

These issues indicated that the provider was not consistently using evidence-based tools to assess, monitor, and respond to people’s needs, which may result in risks not being appropriately identified or managed.

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 told us they generally worked well together and there were systems in place to support communication between colleagues. This helped to ensure that important information about people’s care and support needs was shared.

Staff spoke positively about teamwork and told us they felt supported by their colleagues. Communication systems enabled important updates about people’s care to be shared in a timely way, supporting continuity and safety.

The provider did not always ensure people were supported to live healthier lives through well-informed, person-centred care planning.

We found that care plans lacked sufficient detail in relation to people’s specific health conditions and the impact these had on their daily lives. For example, there was limited information about conditions such as dementia and stroke, and how these should be managed in practice. This meant staff may not have had the guidance required to provide effective, condition-specific support.

We also identified that some language used within care plans was not person-centred. For instance, support with eating and drinking was described as, “Served and fed to me,” which did not reflect respectful or individualised care.

The provider did not always routinely monitor people’s care and treatment to continuously improve it.

People were supported to achieve positive outcomes; however, systems to monitor and demonstrate progress were not always effective.

Feedback from people, relatives and staff indicated that individuals were making progress and achieving goals. However, records did not consistently demonstrate how these outcomes were being planned, monitored, and achieved.

Goals were not always clearly reflected or incorporated within care plans, and there was a lack of clear linkage between identified needs, planned care, and outcomes achieved. This meant it was not always evident what actions staff needed to take to support people in reaching their goals.

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

Staff had completed training in mental capacity and demonstrated an awareness of consent. However, staff feedback indicated that this training was basic and not delivered at a level appropriate to their roles and responsibilities. This meant staff may not have been sufficiently equipped to apply the principles of the Mental Capacity Act (MCA) in practice.

Although people with capacity had signed a consent to care agreement. We were not assured that where people lacked capacity, appropriate mental capacity assessments would be undertaken and recorded. For example, where a person lacked capacity, we were told there were no capacity assessments in place as the person would not be able to take part in the assessment or best interest meetings.

This created a risk that decisions may not always be made in line with legal requirements or in people’s best interests.