The Crown

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 50 (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. We found some care plans contained generic, non‑specific information. For example, one person’s care plan instructed staff to ensure mobility aids were in place, despite the person not using mobility aids. Another care plan included general information about a medical condition rather than describing how the condition affected the person individually or what support they specifically required. This placed people at risk of receiving care that did not meet their individual needs.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards. For example, we identified instances where staff used restrictive techniques without authorised positive behaviour support (PBS) guidance or legal safeguards. When required medicines were administered without documentary evidence supporting their combined use. This placed people at risk of receiving medicines together without evidence it was safe to do so.

The provider did not always work effectively with other teams and services to ensure people received coordinated support. Although referrals to external professionals were made when additional support was required, inaccuracies within care plans and records meant we could not be assured those professionals had access to the accurate information needed to provide appropriate guidance and support.

The provider supported people to manage their health. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

For example, where people required specialist diets to promote weight gain, these were provided. People had regular access to the community and were encouraged to walk as much as they were able to promote exercise and wellbeing.

The provider did not always routinely monitor people’s care and treatment to make sure it was effective and met their needs. For example, we identified concerns in monitoring how people were supported when emotionally distressed, medicines safety and environmental risks. The provider had not independently identified these concerns before our assessment.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. We found legal frameworks for consent relating to restrictive practices were not followed. There were no Mental Capacity Act assessments for the use of restrictive practices and deprivation of liberty safeguards (DoLS) applications did not reflect the restrictive interventions used. This placed people at risk of having their human rights violated.