St Marks Court

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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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.

Care plans were personalised and reviewed. Staff assessed people’s nutrition, mobility, skin integrity, communication and emotional wellbeing and used recognised assessment tools, including MUST for nutritional risk, Waterlow for pressure-area risk and falls-risk assessments.

However, some assessments contained inaccurate or conflicting information. For example, falls-risk assessments did not always consistently reflect people’s known falls history and changing needs, and a choking-risk assessment recorded a score that did not match the selected risk outcome. The wider care plans contained clearer information about people’s needs, but these assessment inaccuracies reduced assurance that records consistently reflected people’s current risks.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff assessed and monitored risks associated with nutrition, hydration, choking and pressure damage. They updated care when people’s needs changed, including modified diets and fluids, fortified food, specialist equipment and repositioning. Staff respected people’s choices, including when they declined food or drinks. One relative told us, “The doctor is there every week. [Person] has a speech and language therapy plan in place.”

The provider worked well across teams and services to support people. They shared relevant assessments of people’s needs when people moved between services.

Staff worked closely with GPs, speech and language therapists, dietitians, tissue viability nurses, continence services, mental health teams, paramedics and other professionals. Referrals included relevant information about people’s risks, current support and previous professional involvement. Staff acted on professional advice and updated care plans when people’s needs changed. This approach was consistent across the sampled care pathways and supported people with multiple and changing needs. A healthcare professional said, “The information [we] receive from the service is clear, accurate and useful.”

The provider 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.

Staff supported people to maintain their health and wellbeing through individualised nutrition, hydration, mobility and pressure care. People at nutritional risk received fortified diets and additional support with meals, while people at risk of skin damage had pressure-relieving equipment and repositioning plans. Staff encouraged people to maintain their independence and make choices about their daily care. One relative told us, “[Person] is eating better now.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff monitored people’s weight, nutritional intake, hydration, skin integrity, mobility and other identified risks. They reviewed this information and adapted people’s care in response to changes. Records demonstrated positive outcomes for some people, including stable weight and improved food intake. One relative told us, “It’s the most I’ve seen [Person] eat in 4 weeks.”

The provider could not always demonstrate that staff followed legal requirements when making decisions for people who lacked capacity.

Staff generally respected people’s choices and refusals, and decision-specific mental capacity assessments were available. However, some assessments contained contradictory information or did not clearly show how staff supported people to take part in decisions. Some best-interests records did not clearly show consultation, the person’s wishes, less restrictive options or the reasons for the decision. Information about lasting powers of attorney and Deprivation of Liberty Safeguards was also inconsistent.

This reduced assurance that staff consistently made and recorded decisions in line with the Mental Capacity Act 2005.