Purple Heart Health Care

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.

This is the first assessment for this newly registered service. This key question has been rated 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.

Care plan guidance for staff, which outlined people’s individual care and support needs, lacked personalised information. Important details such as people’s preferred routines and personal preferences were either not recorded or not described in sufficient detail. As people had no verbal communication, they were entirely reliant on staff knowing this information to ensure their care was delivered consistently and, in a person-centred way.

A communication care plan provided staff with information about people’s communication needs. However, the guidance lacked essential detail, such as how the person expressed pain or what specific non‑verbal gestures, behaviours, or sounds might mean. Without this personalised information, staff did not have the clarity needed to interpret the person’s cues consistently or respond appropriately. Whilst staff knew people well, there was a risk that unfamiliar or temporary staff would not know this information and therefore may not recognise when the person was distressed, unwell, or trying to communicate an important need. This increased the risk of inconsistent care and unmet needs. We discussed this with the registered manager, who confirmed they would review this information and make improvements.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Whilst relatives told us they had been involved in assessments and ongoing reviews, care plan guidance for staff lacked specific, personalised information. We concluded this was a recording issue. However, a lack of reference to people’s personal wishes, preferences, and goals meant there was a risk that care may be task‑focused rather than person‑centred, and people may not have received support in a way that promoted their independence, wellbeing, and quality of life.

Best practice guidance was not consistently embedded in the support provided. The registered manager told us staff had received training in Positive Behaviour Support (PBS). PBS aims to increase quality of life and reduce behaviours of concern by understanding the reasons behind behaviour and creating environments where positive behaviour is more likely. However, care plans did not fully reflect this because they lacked the detailed, proactive strategies associated with PBS. As a result, staff did not have clear, consistent direction on how to apply their PBS training in practice, increasing the risk of reactive rather than proactive support. However, we found no evidence people had been harmed.

Whilst we concluded that staff knew people well, the absence of robust PBS‑informed guidance meant people were at risk of not receiving consistent support in line with best practice or their assessed needs. We discussed this with the registered manager, who agreed to seek further external PBS support.

People’s daily care records did not consistently record their food and fluid intake. The registered manager told us staff were required to record this information. However, the provider’s oversight and monitoring procedures had not identified or addressed this issue.

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.

Staff confirmed the provider’s internal communication systems worked well and were positive about how the staff team worked together. A staff member said, “Staff have a good relationship with the company and colleagues in terms of communication and teamwork.”

The registered manager attended multi-disciplinary meetings with relatives and external professionals where important information was shared and decisions made. This supported the times relatives had to repeat their story.

An external professional was positive about the provider’s approach to collaborative working. Comments included, “I have no issues with the support Purple Heart Health Care have provided over the last 3 years. I can clearly state that we have a good working relationship, and I would not hesitate to recommend them to any third party.”

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.

Care plan guidance provided staff with no information about people’s health conditions or the impact these had on their care and support needs. This meant staff did not have the essential knowledge required to understand how a person’s health conditions affected their daily life, potential risks, or the adjustments needed to support them safely. As a result, there was an increased risk of care being delivered inconsistently, without consideration of important health‑related factors, and not in line with people’s assessed needs.

A relative told us how staff supported them to take their family member to health appointments and how helpful this was.

The provider did not routinely monitor people’s care and treatment to continuously improve it. For example, gaps in people’s daily care records relating to their food and drinks. However,

Relatives confirmed the registered manager had regular contact with them to discuss and review the care package provided. They told us how the care package and support were amended to ensure consistent, positive outcomes. A relative said, “The manager knows [name] really well. They visit every 3 months to review the care package, and each month we have a phone meeting. The manager is very kind, always asks how I'm feeling, how the care is going, if there are any changes required, the communication is very good.”

Another relative told us that the care package was intended to support short-term care until a long-term alternative was found. They were positive about the support provided that met their expectations and more. They said, “The staff are very forward in helping us in any way they can, they ensure care is always provided in the most supportive way, including being supportive towards us. I would absolutory recommend the service to others.”

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

The Mental Capacity Act (MCA) is a law in England and Wales that protects and empowers people aged 16+ who may lack the ability to make certain decisions for themselves. It sets out clear principles for assessing capacity, making decisions in someone’s best interests, and supporting people to be as involved as possible.

The registered manager was not fulfilling their responsibilities under the MCA. Whilst the provider’s policy and procedure stated the registered manager was responsible for completing assessments and best-interest decisions in line with the key principles of the MCA, they had not done so. The registered manager told us they had relied upon external professionals to do this, but would address this shortfall.

Staff were aware of the principles of the MCA and had received relevant training, as well as access to the provider’s policy. We noted care plans lacked guidance for staff about the importance of seeking consent before care was provided. We discussed this with the registered manager who agreed to review care plans.

At the time of the inspection, 1 person had been granted a Community Deprivation of Liberty Safeguard (DoLS) by the Court of Protection. This occurs when a person lacks the mental capacity to consent to their care arrangement. Staff had details on the restrictions in place, and how to support the person in the least restrictive way.