Archived: Curant Care Maidstone

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 require improvement. At this assessment the rating has changed to inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 29 (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 make sure people’s care and treatment was effective because they did not appropriately check and assess people’s health and care.

People’s needs were not well assessed and this needed to be improved to ensure staff had the information they needed to care for people safely. For example, staff were leaving medicine for one person on their table or in a pot. There was no assessment to demonstrate this had been reviewed and was safe to do so. We also identified some health conditions for which there were no risk assessments.

People’s assessments did include discussing people’s equality and diversity needs and these were documented in people’s care plans.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Care and treatment did not always follow guidelines and best practice. For example, how people’s medicines were managed was not always delivered in line with National Institute of Health and Care Excellence (NICE) guidance for adults receiving social care in the community. NICE sets out guidance such as care providers should agree who is responsible for ordering a person’s medicines and documenting this in the care plan. We found this was not always undertaken.

The provider did not work well across teams and services to support people. They did not share their assessment of people’s needs when moving between different services.

Staff did not always have access to the information they need to appropriately plan and deliver people’s care and support as care plans lacked important information about people’s care. Some staff also told us communication from the office needed to be improved. One staff told us, “Sometimes the communication could be better. Just being a bit more informed about things.” However, staff did support each other and shared information between themselves were possible to improve things.

The provider did not support people to manage their health and wellbeing, so people couldnot maximise their independence, choice and control. Staff did not support people to livehealthier lives, or where possible, reduce their future needs for care and support.

People told us most staff supported them well with food and drink. Relatives told us they left meals for people and staff provided people with this support. One person told us, “If someone is new and shadowing, they get told how I like it.”

However, one person told us new staff did not always know how to prepare simple meals, and they told us this meant they were selective about who they asked for help. There were significant concerns regarding the management of people’s health risks as people did not always have appropriate risk assessments in place for the management of conditions such as the risk of choking, falls and constipation.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The manager told us people’s daily notes were spot checked, meaning each month a sample of people’s notes were checked. Daily notes were written in a way which meant we found reviewing notes was time consuming and this could be improved. We also identified concerns in daily notes which had not been identified such as one-person missing medicine and a person falling. Systems to monitor outcomes for people needed to be improved to ensure concerns were identified by staff at the service.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Staff had a good understanding of the importance of supporting people to make decisions for themselves. Staff knew people had the right to make choices they would not make themselves.

However, there were areas where records needed to be improved. For example, the manager told us everyone had mental capacity to make decisions. However, we saw in care plans this was not always the case. One person care plan set out their relative had power of attorney. No copy of this was provided when requested to evidence this was the case.