Eskdale House Supported Living Service

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.

This is the first assessment for this newly registered service. This key question has been rated 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 need for consent. The service did not always ensure people’s consent was gained where required. The service did not always ensure the principles of the mental capacity act 2005 were followed.

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 service 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.

Care plans did not always include up to date, consistent information about people’s needs. For example, where 1 person was receiving a high level of support in relation to their incontinence needs and sleeping needs, their care plan did not include up to date information about this and there was no guidance about how staff should support them. When the inspection team informed the service about this, they sent us updated care plans and risk assessments which included consistent information about people’s needs and how staff should support them and escalate concerns.

Care plans were mostly person centred and included information about people’s social histories and preferences.

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

People’s care, treatment and support was not always delivered in line with national standards or evidence-based good practice guidance.

People received inconsistent support around their nutritional needs. For example, where 1 person had been referred for specialist support in this area, their care plan did not include sufficient information about how staff should support them with making healthier choices and staff had not been monitoring their progress.

Care plans included people’s safe swallowing guidelines; however, we received some feedback from relatives stating [person] had not been supported to eat in line with their support needs.

However, the inspection team observed some good practice where staff had followed a person’s care plan and gave personalised support around their eating and drinking.

The service worked well across teams and services to support people.

Staff told us they worked well together. One staff member told us, “The team is happy, and we work well together. There is a lot of progress happening.”

Staff shared information about changes in people’s needs through handover meetings.

We received mixed feedback about how the staff team worked with external services. One health and social care professional told us, “I have found communication with staff has been very easy, contact with the service manager and supervisors has been appropriate and responses have been in a very timely manner, both via phone and email.” Another health and social care professional told us, “I feel their engagement with me has been positive, and it is clear that the individual is at the centre of everything they do. However, I do feel that communication with families and health professionals could be strengthened.” Another health and social care professional told us, “The [service] is more responsive, and our working relationship has greatly improved. Sometimes I still need to remind them to notify us when things have happened.”

For the most part, the service 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 saw evidence people were referred to health and social care partners for specialist support, where required.

People and staff told us they were living healthier lives since Westmorland and Furness Council took over the service. One person told us, “Things are much better for me since [the new provider] took over. I do more and am much happier.” One relative told us, “[Person] is now under review by [specialist health professional] and staff are really improving things for them. I am really grateful for what the [service] is doing.” One staff member told us, “I feel people are living better lives. For example, [person’s] wellbeing has really improved, and they have become more independent with their care.”

However, improvements were required with care records to ensure staff were given clearer guidance about how to support people with their needs.

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

Systems to monitor people’s care and identify issues were not always effective. For example, where people required support with medication, mobility, incontinence and sleeping.

We found inconsistencies with how people’s needs and risks were monitored and how their outcomes were recorded. We found 1 person was receiving improved support around positive behaviour. However, improvements were required with how they were supported with their eating and drinking needs.

One health and social care professional told us, “There have been improvements in service user [outcomes], however monitoring forms needed to be simplified as the way things were being recorded was leading to inaccurate information.”

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

CCTV was operated in the communal areas of the premises. While there was a fault on the system which meant images could not be recorded and stored, live images could be viewed from a monitor in the staff office. The service had not obtained consent from people about its usage and where people lacked mental capacity in relation to this, best interest decisions had not been made. This meant the provider could not be assured that they had considered the requirements of GDPR, people’s consent or dignity in relation to CCTV.

However, we saw some good examples of where the service had considered people’s consent and mental capacity, where required, for other decisions affecting their daily lives.