Constable Care

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 registered manager worked with people to plan how their needs should be met, not always ensuring 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.

The registered manager completed care plan reviews with people, but there was no clear plan of frequency of reviews, other to update at yearly intervals or when people’s needs changed. The registered manager did not sign anywhere to say that they had checked that people’s need remained the same.

However, people we spoke with felt involved with managing their needs, and that the small and regular staff team naturally adapted to small changes as required.

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.

Care staff had provided support to people recovering from hospital treatment following guidance from health professionals to promote people’s rehabilitation. The registered manager had incorporated professional guidance into care plans, including management of skin integrity, swallowing and supporting people’s mobility.

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.

The registered manager was able to show us examples of cross agency working to support people when their needs changed. This included access to physiotherapists and services to adapt people’s homes to support independence.

One relative told us, “The fact that they are so local means that my [relative] has the same care staff coming and they know them really well. We have a routine and they can spot when things are wrong for [relative] and take the right action, like supporting calls to the GP.”

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.

The registered manager gave examples of increasing care hours to support people to attend GP and hospital appointments if that was something they needed.

One relative told us, “There was a change in [relative] needs and Constable care were able to increase their support. They don’t hurry [relative] in activities.”

The provider routinely monitored people’s care and treatment to continuously improve it, through frequent visits and regular hands-on care provision. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The registered manager gave examples of how the service adapted care approaches by seeking updated needs assessments from commissioners to increase peoples allocated time. Waiting times for reassessment could be up to a month, however, the provider ensured the person received the care required in the interim. One relative told us, “We started off with just a few visits a week, but it was clear we needed support daily. Constable care quickly supported this which has had a positive impact on us.”

The provider did not always tell people about their rights around consent or respect these when delivering care and treatment. However, people’s care plans clearly stated when people had capacity to make decisions.

Staff had not undertaken Mental Capacity training, and the registered manager’s knowledge of mental capacity required refreshing. Staff would secure one person’s home preventing them to leave due to concerns around risk of wandering following an incident. The provider had done this on advice of professionals and agreement with family members. However, the legal framework had not been applied. There had been no application to the court of protection, resulting in unlawful restrictions.

The provider took immediate action to update staff and the registered manager training in Mental Capacity and Deprivation of Liberty safeguardings. They took immediate action to ensure that the proper assessments and applications took place to ensure least restrictive practices.

People told us that staff “always gave them a choice and respected their decisions, and this was evidenced in care plans and daily care entries. One relative told us, “They speak to my [relative] and explain to them what they are going to do step by step. They take their time, they seek permission.”