New Villas Office

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.

Requires Improvement: This meant the effectiveness of people's care, treatment and support did not always achieve good outcomes or was inconsistent..

The service was in breach of legal regulations in relation to person centred care and the need for consent. This was because people care plans were not always updated to reflect their changing needs and the provider did not always comply with the principles of the Mental capacity Act 2005 in relation to consent to care.

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,wellbeingand communication needs with them.

People’s needs were assessed before they moved into a home managed by the providerand started being supported by New Villas Office. People and those important to them took part in assessments and their views and opinions were listened to and respected. However, care plans that were developed from theinitialassessments did not always provide up to date information, nor did they ensure that staff supported people toidentifyand work towards their aspirations and goals. When people’s needs were assessed, the provider did not always consider the environment and how New Villas Office staff would support them in their home. People’s communication needs were assessed and met. People who did not always communicate well verbally had clear dictionaries and glossaries of what their vocalisations meant so thatnew staffworking with them could understand. Staff who had been working with people for a while knewthem and their communication needs well. Weobservedseveral positive instances of this through our inspection visits. The service provided people’s care and support documentation to them in formats they couldunderstand, including easy read and using pictures.

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

Care plans we viewedcontainedinformation that had not been updated for some time.It was not always clear what people’s goals and aspirations wereor how staff were helping people to achieve them.Thereforethere was no record of progress in care plans.

Some of the care plans we viewed included goals that the person was undertaking already, despite the care plan having been reviewed recently. Similarly, records people’s regular meetings with their keyworkers showed that the same topics were discussed each session, with very few changes, and the aspirations for the people detailed there were aspirations they had already achieved.

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.

Contactwe received fromsome professionals and staff showed thatcommunication both internally and externallywas not always open and transparent. For example,one staff membertold us they were not made aware of significant changes to the care of a person until the very last minute. Thisindicatedthat theassessmentand decisions taken were done so without feedback or input from care workers whoknow the person well.

Oneprofessionalteam described the service as obstructing the smooth transition of a person who was moving out of the service.

The provider did not always support people to manage their health and wellbeing, so peoplecould not always maximise their independence,choiceand control. Staff did not always support

people to live healthier lives, or where possible, reduce their future needs for care and support.

As people did not always have upto date care plans,independence choice and control was not alwaysevident.At least one person was unable to access outside space at the service without supportfrom staff, despite this being a safe area. Due to a lack of recorded progress in care plans, it wasnotevidentwhether any progress took place with regards to reducing future needs or support where possible.

The provider did not always routinely monitor people's care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Some of the care plans we viewed had not been updated. People had not always been involved in updating their care plans. One care plan we saw showed no clear goals and lacked detail in staff support needed to meet them. There was also no celebration of any achievements toward these goals, showing a failure in monitoring outcomes.

We also saw evidence that complaints were not always recorded as such and therefore responses to complaints were not available to show learning and outcomes.

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

Although the provider was aware of the requirements of the Mental Capacity Act 2005, this did not always result in people receiving a service in which their capacity was presumed and their rights protected.

Staff generally supported people to make day-to-day decisions about their lives such as what they would wear, what they would eat and community activities. However, these were provided with limits and we saw that many people supported by the service chose the same activities, such as attending the provider's day centre in the address they lived.

Although people's records contained some limited assessments of people's capacity to understand and make some decisions, they did not always include documented best interests decisions exploring all options available to people including less restrictive alternatives. Where people had been assessed as not having capacity to understand and make decisions, their next of kin had consented to aspects of their care and support without any evidence the family member had legal authority to make decisions and consent on the person's behalf. For some people, appointeeship by the Department of Work and Pensions, which is where a person is appointed by the DWP to manage financial benefits on behalf of a person who doesn't have capacity, had been confused in their records with deputyship authorised by the Court of Protection. These structures provide different levels of authority and decision-making, and convey different legal authorities on the person appointed or authorised and confusing them leaves people without capacity at risk of not having their rights protected. The service facilitated access to independent community and statutory advocates for people when they needed support to understand and make significant decisions.