Elysium Care Partnerships Limited - 1a Upper Brighton Road

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.

We identified the service was in breach of legal regulation in relation to safe care and treatment.

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.

People had detailed care assessments including communication, eating and drinking, missing community access, night-time support, sexual safety, and people had individual sensory plans.

Staff also knew people well and could describe individual triggers, choices, communication methods and health needs. The positive behaviour support lead described examples of personalised work, including grief support, involving relatives, anxiety support and strategies to reduce distress. This helped staff provide care that reflected people’s histories and needs.

However, the assessment of people’s needs was not always kept up to date. Some records were out of date, reviews were overdue, and risk assessments were not always updated when circumstances changed. For example, some hospital passports in some records were out of date. This meant the provider could not always evidence that people’s current needs were accurately assessed, managed and reflected accurately in their records.

The provider did not always plan and deliver care and treatment in partnership with people, including consideration of what was important to them and their individual preferences.We identified some areas of good practice in relation to delivering evidence-based care and treatment. Staff used positive behaviour support (PBS) approaches, trauma-informed care principles, communication tools and personalised activity plans to support people effectively. The provider's PBS team delivered face-to-face training and worked alongside staff to review and assess changes in people's behaviours, helping to promote consistency in care delivery.

There was evidence that staff sought and followed specialist advice when supporting people with complex health needs. Staff worked collaboratively with a range of healthcare professionals, including epilepsy nurses, gastroenterology services, psychiatrists, learning disability nurses and dietitians. This supported people to receive care and treatment that reflected their assessed needs and helped minimise distress.

However, the provider could not always demonstrate that evidence-based care and treatment were delivered consistently. Although a physical health policy was in place, it did not include guidance on the management of constipation or epilepsy for people with a learning disability and autistic people. This was particularly important as some people may experience difficulties communicating pain, discomfort or deterioration in their health.

Records were not always accurate, current or easy to navigate. We found examples of duplicated and out-of-date information, which increased the risk of staff relying on inaccurate guidance. As a result, the provider could not be assured that systems and processes were always effective in identifying and responding to people's changing needs promptly and appropriately. This meant people were at risk of receiving care that was not consistently planned and delivered in line with current evidence-based practice and recognised guidance.

This is further evidence of a breach in relation to safe care and treatment.

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

We found some shortfalls in how staff, teams and services worked together. The service had links with external professionals and internal specialist teams. The PBS lead supported staff and residents, quality leads visited and audited the service, and staff worked with epilepsy nurses, learning disability nurses, gastroenterology teams, psychiatry services, dieticians, local authorities and families. The service also used local bank staff and shared resources with other homes when needed.

Staff described good working relationships with managers and each other. The manager described daily 30 to 40-minute handovers, team meetings, supervision and sharing learning from incidents across services. This supported communication and continuity.

However, daily handovers lacked detailed information and used generic statements. Handover records did not describe incidents in any detail. This increased the risk that staff teams did not have clear, shared information to guide care on a day-to-day basis.

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.

Although there were examples of good practice, the provider could not always demonstrate they were supporting people to live healthier lives. People were supported to attend appointments and receive health input. Staff supported people with activities such as walks, days out, community outings and garden activities. These opportunities supported wellbeing, health and quality of life.

However, some health monitoring was inconsistent. Care records showed that some physical health risks were not consistently recorded to ensure symptoms were identified in a timely way and responded to reduce the potential risk of harm.

Relatives told us people could be more independent within the home, have more choice in activities and have more opportunities to go outside in the community.

The provider did not consistently monitor people’s care and treatment to drive continuous improvement. As a result, they could not always demonstrate that outcomes were positive, consistent, and met both clinical expectations and the outcomes that mattered to people.

Staff understood people’s individual needs and preferences and supported them to attend meetings with external professionals. This helped ensure relevant information was shared to inform healthcare assessments and decisions about people’s care and support.

However, care records did not contain concise profiles that summarised key information about people’s needs, preferences and support requirements. This meant new or temporary staff may not always have access to essential information to support people consistently and reduce the risk of distress or anxiety. In addition, care plans lacked evidence of aspirational goal setting, planning and regular review.

People told us they were not routinely involved in outcome planning for their relatives to identify outcomes that reflected their choices and aspirations. Although leaders described new processes that were intended to improve the identification and monitoring of care outcomes in partnership with people and their relatives or representatives, these had not been implemented. Therefore, we could not be assured that people’s strengths, skills and life experiences were routinely explored and used to inform planning for their short, medium and long-term goals, ambitions and desired outcomes.

This is further evidence of a breach in relation to safe care and treatment.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood that many people did not use verbal communication and described how they gained consent through observation, body language, PECS, Makaton, picture cards and touch confirmation. One staff member described offering choices such as bowling or football and using picture cards or touch to confirm the person’s choice. This helped people express consent and preferences in ways that worked for them.

We observed one person consenting to show us their room by nodding and leading the way. Staff respected the person’s communication and followed their lead. Another person was being supported and staff used body language and Makaton to communicate next steps in their activity. These observations showed staff were attentive to non-verbal communication and did not rely only on spoken consent.

The provider had Mental Capacity Act and Deprivation of Liberty Safeguards policies and trackers in place. DoLS applications and reviews were recorded, and records included best interest and court of protection documentation.