Crown Mews

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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.
 

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them. People’s care plans had recently undergone a comprehensive review and were found to be detailed and robust. The service had also recently implemented regular keyworker sessions, providing people with opportunities to discuss their support plans as well as any personal goals or aspirations. Relatives reported that, historically, they had not felt sufficiently involved or included in reviews. However, they told us that this had begun to improve in recent months. One relative told us, “With the care plan, I was pushed away because they said they needed to develop their own. But now the good things that are happening are the result of my intervention.” However, work to consistently involve people and their relatives in reviews of care and support was still being embedded at the time of our assessment.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Care plans clearly identified people’s complex needs, including specific dietary requirements. People were supported to plan meals and complete their own shopping in line with their preferences and dietary needs. They were able to eat and drink when they chose, and staff supported people to prepare meals at times that suited them. Staff supported people to prepare their own meals, promoting independence and choice.

The provider worked well across teams and services to support people. Staff understood each person’s individual care needs and helped them access services and attend appointments. These included specialist appointments as well as routine healthcare. Staff from different disciplines worked together as a team to benefit people. They supported each other to make sure people had no gaps in their care. Effective handover processes were in place between each shift to ensure all appropriate information was passed onto staff in a timely manner. The service worked closely with healthcare professionals such as occupational therapists, learning disability teams and psychologists to maintain and improve people’s wellbeing. There were records of people healthcare appointments and any changes in care were communicated to the staff team to ensure people were appropriately supported with any changes in healthcare needs. Relatives reflected on recent improvements in this area with one person stating, “The outside nurse specialist has made a big difference…now they [staff] seem to be listening.”
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice, and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff supported people to attend healthcare appointments, monitored their health needs effectively and reported concerns promptly. There were clear records of appointments and health and wellbeing reviews. One relative told us, “They look after [family member] really well…and are on top of checking them medically.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Staff worked effectively in partnership with external professionals to improve outcomes for people they supported. They demonstrated a strong understanding of individuals’ needs and how best to support them in achieving both health-related outcomes and an enhanced quality of life. Professionals spoke positively about the service, particularly highlighting the impact of the provider’s internal Positive Behavioural Support team. One professional described having “a certain degree of confidence” in achieving positive outcomes for an individual when this team was involved.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Staff demonstrated an understanding of consent and how it should be applied in practice, supported by training in the Mental Capacity Act (MCA) 2005. However, we identified that, until recently, one person’s access to food stored in their kitchen cupboards had been restricted by staff without appropriate authorisation or a clearly evidenced rationale. This issue had been identified by the provider’s Quality Manager shortly before our assessment commenced. At the time of our inspection, all such restrictions had been removed. The provider acknowledged that this established practice had not been recognised as a potential restriction, nor been appropriately challenged by staff. The management team had begun to address this by working to embed a cultural shift within the staff team, promoting greater awareness of choice, autonomy, and least restrictive practice. This work was still in progress at the time of our assessment. Care plans included clear information on individuals’ mental capacity, with appropriate capacity assessments and best interest decisions documented where required.