Archived: LLOYDS CARE GROUP LTD

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 requires improvement. At this assessment the remained 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 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Whilst people and staff told us their care was effective as they were included in discussions about their care and wellbeing, documentation did not always evidence this support or people’s desired outcomes. The provider did not always make sure people’s care and treatment records were documented effectively, reviews and updates to care plans were not done in line with people’s changing needs and quality and audit processes in place had not identified this concern. For example, one person had experienced an increase in falls and now required 2 staff members to support them at each visit. Neither the person’s care plan or risk assessment had been updated to include this information. Another person required help to manage their condition related to addiction, however their care plan did not detail this risk, how staff were required to support the person or what staff needed to do if they had concerns relating to the person’s care. This placed people at risk of harm from known risks not being assessed and recorded effectively.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Care plans lacked detail on people’s health conditions and social histories. Where people required support to manage behaviours including periods of anxiety and aggression, care plans and guidance had not been put in place for staff to help keep people safe. We saw examples of a person experiencing incidents of aggression towards staff. However, incident forms had not recorded these events, and no follow up action had been taken to support the person or staff involved.

Despite care plans lacking elements of person centred details, people and staff told us the provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. One relative said, “They [staff] are very good, they know how [relative] likes their care and know their condition well, so they contact me very quickly if they notice any changes.”

Despite care records not always documenting recommendations and advice from other professionals involved in people’s care the feedback we received from people and staff stated the provider worked well across teams and services to support people. They made sure people were supported to access services and other medical professionals as required. One relative said, “My [relative] sees an occupational therapist and staff always follow this guidance, so I know [relative] is safe with staff.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Where care plans detailed support people needed, daily records did not show that staff had followed people’s care plans. For example, one person was at risk of self-neglect and required support and prompting with their personal care. Daily notes from visits completed by staff did not record information about this support meaning the provider could not be assured people had received the care required to keep them safe and support their wellbeing.

The provider did not always routinely monitor and record people’s care and treatment to continuously improve it. They did not always ensure that outcomes met clinical expectations. For example, where people had experienced an increase in falls, this had not been recorded within their care plan. This meant the management team did not have oversight of any pattern or trends about people’s developing condition or how this affected their care outcomes and personal goals. Where people require support and monitoring with risks to their health such as tissue viability, care plans did not detail whether these checks had been completed or the outcome. This meant that people were not supported effectively or safely, however we found no evidence that anyone had come to any harm due to this concern.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. Care plans contained conflicting information about people’s capacity and ability to consent to care and treatment. Where people lacked capacity to make decisions, despite their care plan stating staff were to support them by making decisions in their best interest, there was no evidence this had been done. There was no guidance for staff on how to support people. Staff received training regarding the Mental Capacity Act 2005 (MCA) however, we saw limited evidence in people’s care plan that the 2-stage capacity assessment had been completed to legally and ethically determine if someone lacked the capacity to make a specific decision at a given time.One person’s care plan assessment stated they had full capacity and were independent, however a professional who worked with this person told us the person had a court of protection order in place meaning restrictive care arrangements were legally authorised in the person’s best interest. The manager acknowledged they were aware of this restriction but could not tell the assessment team how this affected the person, or the care which staff were required to give. This placed the person at risk of harm.