Penniston Barn

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,treatmentand support achieved good outcomes and promoteda good qualityof life, based on best available evidence.

At our last assessment we rated this key questionoutstanding. At thisassessmentthe rating has changed torequires 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.

People's needs were assessed before they received support and care plans reflected what was important to them. Staff knew people well and there was evidence that people's needs were reviewed regularly, including involvement from relevant health and social care professionals where required. However, assessments and care planning documentation were not always clear, consistent or easy to follow. Information relating to people's needs and risks was often spread across multiple documents, including care plans, positive behaviour support plans and behaviour management plans. This created a risk that staff may not always have access to the most up-to-date guidance. We also found inconsistencies between records and examples where important health information was not reflected across all relevant documents.

Care and treatmentwasnot always planned and delivered in line with best practice. Care records were not always clear or consistent, withimportant informationrecorded across multiple documents, increasing the risk of inconsistent support. Communication support was not always provided using people's preferred methods and opportunities to promote healthier lifestyles were not consistently maximised. However, staff knew people well and supported them to develop independence,maintainlifeskillsand achieve positive outcomes.

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. One relative said, “I did a pen picture for the staff when [Relative] moved in to help the staff spot signs and things to look out for. Now they are good at spotting signs and preventing or managing behaviour issues.”

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, for example, menus were heavily reliant on processed and frozen foods, including items such as burgers, pizza and chicken nuggets. There was limited evidence of staff actively promoting healthier eating choices or supporting people to make balanced dietary decisions whilst respecting their preferences.

The provider did not always routinelymonitorpeople's care and support to drive improvement or ensure positive and consistent outcomes. Incident records, accidentreportsand antecedent-behaviour-consequence (ABC) monitoring were not consistently analysed for trends,patternsor themes.Opportunities to review people's care,identifypotential triggers and implement proactive strategies to reduce distress were sometimes missed. This meant the provider could not alwaysdemonstratethat care and support had been adapted in response to learning or that outcomes consistently met people's needs and 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. Where people lacked capacity to make specific decisions, Mental Capacity Act assessments and Deprivation of Liberty Safeguards applications were in place where required. However, records did not consistently demonstrate that best interest decision-making processes had been fully completed. There was limited evidence detailing the options considered, consultation undertaken or the rationale for decisions made on behalf of people.