Stratford Road

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 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 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. The provider failed to appropriately assess a person’s needs around safety. The restrictions which were disproportionate to the person’s needs. Despite the person telling the provider restrictions in place were not necessary, the provider did not carry out further assessments to address this.

Not all parts of the providers care planning system had been completed. There was no evidence to suggest people’s futures had been discussed. In both care plans reviewed, these sections were blank. A family member told us they were involved in their relative’s care. They told us, “We are able to discuss [relatives] care, and I feel I can talk to the managers about any aspect of it.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. They did not use restrictions correctly or evaluate them to identify whether they were proportionate to risk. They also did not act upon what the person had said about the restrictions.

Staff did not always follow CQC’s right support, right care, right culture. They did not always involve people in conversations about them or always act to maintain people’s privacy and dignity. For example, whilst a person slept in their room a staff member went in without knocking.

People were supported to eat food of their choice and were offered a balanced diet. Staff appropriately recorded what people ate and drank in people’s care notes which helped monitor people’s wellbeing. People were supported to access health services they needed and follow up appointments happened to ensure people remained in good health.

The provider worked well across teams and services to support people. Managers and staff told us they worked well together to support people in delivering people’s care. A professional we spoke with told us how the work they did was supported by the managers which made their job easier and more effective. They told us, “I have been working with the team recently. Without their contribution and input, it would have been very challenging to complete the number of documents needed.”

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 told us how they acknowledged people’s rights to eat what they wanted but used their knowledge to provide people with information about promoting healthy eating and decision-making. They added, “We have the conversations about eating junk food, making it clear that now and again is OK. We talk about such things as how much sugar is in what we eat and how this can sometimes be unhealthy. We also help people create their menu plans and shopping list, advising them about things they might like which are healthy.”

The provider routinely monitored people’s care and treatment to continuously improve it. They worked alongside other professionals to ensure that outcomes were positive. People had routine health appointments as well as appointments about specific medical conditions. Information was recorded which gave a clear indication about people’s health journeys, from where medical conditions were diagnosed and the path that people were supported to take to ensure the right health outcomes were met.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Mental capacity assessments did not cover all decision making areas for people. There was no capacity assessment in place for a person around physical restrictions in their home. The person told us they did not want the restrictions. They told us, “I don’t want these [restrictions on windows]. They are everywhere and I have told them I don’t want them.”

People can only be deprived of their liberty to receive care and treatment and appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005.

We saw a DoLS order in place for 1 person. We saw information about restrictions to a person’s windows in their DoLS which had not been risk assessed and had not been put in place to manage the person’s safety. We have asked the provider to look into this matter urgently and to evidence how they were exploring reducing restrictive practices while meeting safety recommendations.