Coppice 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 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.

Whilst people’s care was reviewed, these reviews did not identify gaps in people’s care and where people may need additional support. People’s communication needs were not followed and reviews with people by staff did not reflect how staff had supported people to communicate using their preferred methods. For example, we reviewed people’s ‘resident meetings’, these meetings aimed to capture people’s experiences about their care however in several forms we reviewed there was no evidence of how people’s communications preferences were used in line with their care plans. This meant the service was not meeting right care, right support, right culture.

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

Where people had been assessed or reviewed by SALT (Speech and language therapy team) their care plans did not always reflect the most up to date accurate information about their individual needs including their assessed IDDSI levels (a framework standard for describing food textures and fluid thicknesses for people who have swallowing difficulties). This put people at increased risk of harm of being given the wrong type of consistency with their food increasing the risk of choking for that person.

The service had adopted a general policy assigning everyone a specific IDDSI level without the input of a specialist professional from the speech and language therapy team. This approach meant some people were recorded as requiring a specialist diet where they may not need one. Aside from this staff were not following the guidelines and people were given foods which may not have been appropriate for them.

However, staff we spoke with were knowledgeable about people’s dietary requirements. One staff member told us “Some service users are allergic to certain foods and if we see any issues with anything we report to management and the Team Leader will report to the manager. We have 4 residents with SALT guidelines (following an assessment from the speech and language therapist). When a new staff member comes in, we give them an induction and orientation. They must read all the care plans so they can know everything for how to support people”.

Following our feedback the provider reviewed people’s needs and made the appropriate referrals to health care professionals where needed.

Staff worked well across teams and services to support people. People were supported to access healthcare professionals such as GP's and dentists when needed. Staff supported people to attend medical appointments and worked alongside health professionals. For example, there was good evidence of people linking in with primary health care, acute services, specialist services for learning disabilities, speech and language therapy, psychiatry and a nutritionist.

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.

The service did not always identify risks to people to prevent a deterioration in their health and wellbeing. Monitoring of some people’s fluid intake where increased risks were known did not take place putting people at increased risk of dehydration.

Staff told us they knew the signs to look out for in people when they were becoming unwell and how they would escalate this to the management team where there were concerns.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

Whilst the service involved the support of health care professionals in some decisions about people’s care and treatment, they did not always escalate to the right agencies when people’ were experiencing changes to their health.

People had allocated keyworkers, this was a designated member of staff who supported them and oversaw their care. They reviewed people’s care plans monthly and supported the person to identify goals. Some people had goals that were being met for example going to the gym regularly, swimming weekly or horseriding.

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

During the assessment we observed people without access to drinks in communal areas throughout the days we were on site, when we asked why this was, we were told it was because one person presented a risk for people who had drinks in communal areas. There was no clear rationale why this blanket approach had been applied to people. All people living at the service had varying degrees of 1:1 intervention to support them safely in communal areas. People could not consent to this arrangement, and appropriate assessments were not in place for individuals to support this decision.

We identified good examples of some mental capacity assessment and best interest decisions where people lacked capacity to make specific decisions.