Caraston Hall

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 71 (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 needs were assessed before admission, and care records highlighted key information such as risks and communication preferences. Support plans were clear, detailed, and person-centred, outlining how staff should support people to meet their needs. Where required, healthcare professionals were involved in assessing needs and providing guidance in line with best practice, which led to good outcomes for people.

People’s involvement in developing their care and support varied according to their needs and preferences. We noted that some individuals required information in accessible formats, such as different languages, and this was being provided.

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.

People received effective care and support because they were supported by a staff team that received regular training and had a good understanding of their needs. Staff demonstrated a caring approach and had a good understanding of what mattered most to people, which positively influenced the culture within the service. This meant people’s choices, experiences and expectations were promoted, helping to enhance their quality of life.

Senior staff understood the importance of promoting choice, control, independence, and inclusion to improve people’s quality of life. Values‑based practice and effective leadership oversight helped ensure people received care that was person‑centred and aligned with best practice guidance.

People were supported to have enough to eat and drink to maintain their health and well‑being. Staff knew people’s food preferences well and explained how they encouraged and supported individuals to be involved in choosing, planning, and preparing their meals. We found that people made daily decisions about what they ate and drank and when.

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 provider had systems and processes in place to support the effective sharing of information with external professionals, including local hospitals, GP practices, primary care services and, where appropriate, relatives. Records showed that staff worked collaboratively with healthcare professionals and shared relevant information to support consistent communication and coordinated care.

One healthcare professional told us, “I mostly engage with the manager and deputy manager. Both understand and exemplify multi‑agency working. They are thoughtful and caring about the people they support but also have a clear understanding of professional boundaries and risk. They fully engage with our core group approach to providing care and mental health support.”

Staff described how daily handover meetings helped to ensure all staff were kept up to date with changes to people’s support needs.

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.

People were encouraged and supported to engage with a range of healthcare services, and staff supported people to attend appointments. People had access to GP services, pharmacists, and other healthcare services as needed to meet their day-to-day health needs. Staff continued to support people to manage their mental health and where concerns had been identified, people were referred to or reviewed by an appropriate healthcare professional. One healthcare professional said, “I have found the staff generally warm, engaging, and thoughtful. There are often reasons for them to report back to us. The documentation is detailed enough as well as concise.”

People were encouraged and supported to maintain links within their communities to help prevent social isolation. Support plans included information about people’s hobbies and interests, and individuals had opportunities to socialise and take part in activities if they wished to. For example, we saw that one person was regularly supported to go to the pub, eat out, visit the barbers, or simply get a takeaway and enjoy a quiet night in.

People were encouraged and supported to maintain contact with their relatives and others who were important to them. For example, we saw how staff supported one person to travel abroad to see friends and family.”

Relatives had confidence in the staff and told us their loved ones were supported to manage their care, support and health needs by staff who knew them well.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Systems to monitor and improve outcomes were effective. The provider had processes in place to ensure people’s care and support were continuously monitored and reviewed to promote good outcomes. People received individualised care that was flexible and responsive to their needs, delivered by staff who knew them well. Support plans were informative and described people’s strengths alongside the support required from staff and other services. Risk management plans guided staff on how to support people with complex needs in ways that minimised distress. Staff were skilled in delivering care and understood their role in enabling people to develop new skills, gain confidence, and lead full and active lives.

The provider carried out quality assurance through home visits, surveys, and audit systems, which identified issues and enabled prompt action to address any concerns.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However more work was needed to ensure documentation reflected best practice guidance.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack the mental capacity to make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

The provider had policies and procedures in place to support people in understanding their rights. Records showed, and staff confirmed, that training had been provided in safeguarding adults, the Mental Capacity Act 2005 (MCA), and the Deprivation of Liberty Safeguards (DoLS). The registered manager and staff spoke about the importance of obtaining consent and applying the principles of the MCA.

However, some mental capacity and best‑interests documents lacked a person‑centred approach and were not always completed in line with the principles of the MCA. The registered manager acknowledged that updates were needed to better evidence person‑centred decision‑making. While no one had been placed at a disadvantage, we have recommended that the registered manager review this documentation to ensure decision‑making is applied and recorded consistently.