Aspens Cornford Lane

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.

There were variations across the service in how well people’s health needs and capacity to consent were assessed, monitored and recorded.

People’s needs were fully assessed and this included detailed information about the best ways to communicate effectively.

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 provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s health, social and emotional needs were assessed before they moved to the service. People were invited to visit the service and meet staff before deciding if they wanted to make the service their home. Assessments were used to develop the person’s care plan.

Most people had a one page profile which set out the most important information that staff needed to know about them to be able to support them in the right way. Staff were knowledgeable about people’s care and support needs. They were able to describe peoples preferred routines, the best ways to communicate with people and how to support people with their physical and emotional well-being.People had communication passports. These are tools to guide staff about how people with limited or no verbal communication present when they were happy, sad or in pain.

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.

The provider used positive behaviour support (PBS) which is a recognised proactive support framework for people who find it difficult to communicate their anxieties. PBS had been introduced by the provider 3 years ago and was embedded into staff practice and had changed the framework of support which was provided.

Staff had received accredited training in supporting people where physical interventions had been identified in their risk assessments and PBS plans. The training focuses on managing people’s anxieties and promoting a positive and safe environment for everyone involved.It equips staff with skills to assess, prevent, and manage challenging behaviour, while also emphasizing positive behaviour support and strategies to improve quality of life.

People’s needs around their eating and drinking had been assessed and guidance sought from health care professionals. At lunchtime we observed staff supporting people to eat and following this guidance. Staff sat alongside people so they were at an appropriate level to support people safely to eat.

The provider did not always work well across teams and services to support people.

The service worked with a wide range of health and care professionals including community learning disability nurses, community mental health team, speech and language therapists and occupational therapist. Where guidance had been provided by these professionals we saw it had been recorded in people’s care notes and that it was followed by care staff.

We received inconsistent feedback from health and social care professionals about how staff, teams and services worked together. Some professionals were positive about working relationship and others less positive. One health professional told us, “I have had to follow up multiple times for information, as agreed timelines for response have not been adhered to.” Some professionals told us that staff had not always taken on the responsibility of ensuring people attended follow up medical appointments. After people have a medical treatment or a medical procedure they are required to attend an appointment or undergo tests. However, staff had not always supported people to attend these appointments to monitor people’s health.

The provider did not always support people to manage their health and wellbeing or support people to live healthier lives.

People had health action plans which set out what people need to do to keep healthy and how to access services to live a healthy life. The majority of these plans were detailed and contained important information to ensure people’s health was monitored to ensure people lead healthy lives. However, some of the sections on people’s health action plans were blank which indicated that people’s health care was not being effectively monitored. Relatives told us that staff monitored people’s health care although sometimes they had to prompt staff to do so.

People told us that staff supported them if they felt unwell. One person told us, “If I felt unwell, I would be able to tell the staff what the problem was. They would call the doctor if necessary.” Staff or family members supported people to attend medical appointments and although a record was made of these appointments this was not consistent across the houses. Health professionals told us that when people were supported by staff, they knew well there was a positive outcome as staff gave them accurate information about people’s needs. However, when staff did not know people well, they had not always been given accurate information.

Some health care professionals told us that when they had suggested interventions, staff had responded negatively that they would not work before trying their suggestions. They also told us not all staff were aware of people’s exercise programmes to help ensure people led healthy lives.

There was inconsistency in how the provider monitored people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Care records did not evidence that people’s health and wellbeing was routinely monitored. People had missed health appointments and the dates of these appointments had not been recorded until it had been brought to the providers attention.

People had been consulted about their goals and aspiration as part of their person-centred care. However, there was some inconsistency about the regularity of these reviews across the service. Therefore, it could not be certain some people’s goals reflected their current aspirations. Some people had been given clear steps to work towards to help the person achieve their goal on a long-term basis. A new goal planning book had been developed to help people track the steps they needed to undertake to reach their goals. Goals included all aspects of people’s lives including independent living skills and social activities. Communication tools had been used to help people express their views. For example, one person had photographs and pictures to help them decide where they would like to go on holiday.

People’s care was regularly reviewed. There had been a reduction in the use of agency staff which had resulted in more positive outcomes for people. This was because people were supported by a more consistent staff team.

Staff understood the importance of gaining people’s consent but capacity assessments did not always follow the principles of the Mental Capacity Act 2005 (MCA).

Staff described how they offered people choices including what to wear, what to eat and how to spend their time. We observed staff practice during lunchtime. Where people needed additional support to make choices, alternative methods were used to communicate with people. This included visual aids such as pictures, signs or objects of reference. Objects of reference arephysical items used to represent a person, place or activity.

We checked whether the service was working within the principles of the MCA. Where people were assessed as lacking capacity to make decisions, appropriate procedures were not always followed. Where people could not give informed consent, mental capacity assessments had not been consistently undertaken according to best practice. Some decisions had been recorded without evidencing that people had been assessed to check if they could understand, retain, and weigh up the information to communicate their decision. Some people’s capacity had been assessed for multiple decisions at the same time without evidencing the steps undertaken to assess each specific decision. Also, it had not always been recorded which people had been involved in making a decision in people’s best interest.