Lincoln 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.

The provider was in breach of the legal regulations relating to people’s capacity and consent.

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 was effective.

We saw there were assessments completed before people started using the service. However, these assessments were not always used to consistently develop detailed care plans and risk assessments for all people for example when people were living with Diabetes, care plans did not always contain detailed information such as what their blood sugar readings should be.

However, people and relatives felt involved with the assessment process and were aware of people’s plans. One relative told us, “We have a copy of his care plan. They have a copy too.”

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

The scheme and operations managers were unable to fully explain what right support, right care, right culture guidance was and how this was implemented throughout the service.

As reported throughout this report, right support, right care, and right culture guidance was not always fully implemented as people were not always at the centre of their care. Improvements were needed to ensure all people were involved with the reviewing of their care, had achievable outcomes and goal setting as part of this process.

Not always delivering an evidence-based model of care meant we were not assured that people consistently received care and support that met their individual needs or promoted good health and well-being outcomes.

The provider worked well across teams and services to support people.

Relatives were happy with how all the services worked together. They told us they were always updated and felt involved. One relative said, “We went on holiday and he had a fall. [The manager/member of staff] was straight on the phone to ask my permission to get him checked at the hospital. They were so thorough.”

Staff worked well together, this included sharing information about people through daily notes and handovers. There was a system in place to ensure the staff team worked together and alongside other professionals if needed to deliver care to people.

The provider did not always support people to manage their health and wellbeing to maximise their independence, choice and control.

People’s health needs were not always effectively managed. For example, 1 person’s records showed they lived with Diabetes and required their blood sugars to be monitored. There were instructions within the care plan of what staff needed to do if these blood sugar readings were low. However, there was no record in the care plan that stated what low blood sugars meant for this person and staff gave us conflicting information. Although no one had a Diabetes diagnosis at the time of our inspection, the systems in place to ensure their needs associated with Diabetes were safely and consistently managed when they regularly accessed the service for respite were not effective.

However, people and relatives confirmed people’s health needs were responded to. A relative told us, “Never had a problem.”

Other people had individual care plans and risk assessments in place for their health needs and staff were aware of these.

The provider did not always routinely monitor people’s care and treatment to continuously improve it.

We discussed monitoring outcomes with the management team who told us they did not take the lead on this for people. The scheme manager told us as part of people’s care plans, outcomes for people were considered, however records we viewed did not always support this. A staff member told us how they had supported a person to independently complete an activity that they were learning outside of this service. However, they confirmed there were no records in place for this and no goals setting or outcomes recorded, meaning we could not be assured this was planned and completed as part of this person’s care. This meant the lack of information placed the person at risk of not consistently completing this task.

Reviews were taking place for people; however, these were not consistently completed or identifying when changes or improvements were needed. There was not always evidence to show people and those important to them were involved with this process. They did not always consider how people’s care could be improved, through setting goals for people or considered how outcomes for people were measured.

The provider did not always work within the principles of The Mental Capacity Act 2005.

There were some capacity assessments and best interest decisions in place for people when needed, however, these had not always considered all relevant aspects of people’s care. For example, areas such as finances and when people had restrictions placed upon them were not always considered and some mental capacity assessments only covered medicines management.

When capacity assessments had been completed for people in relation to the management of medicines, there was not always best interests’ decisions in place for this when required.

However, staff had received training in this area and were aware of how people consented to their care.