Because We Care Northampton

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 requires improvement. At this assessment the rating has remained 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 regulation in relation to consent to care.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Initial assessments were carried out before care commenced to ensure the service could meet people’s needs, and care staff demonstrated an understanding of people’s needs. However, assessments did not always consider people’s preferences and routines, and updates were not consistently made when people’s support needs changed. For example, restrictions were placed on a person in relation to the management of their personal shopping and this had not been recorded in the person’s care plan. This meant care plans were not always reflective of current needs, which placed people at risk of receiving care which was not effective or responsive.

Leaders did not consistently apply current legislation, national standards, or evidence-based guidance such as NICE guidelines, when planning and delivering people’s care. People’s nutrition and hydration needs were assessed and recorded in care plans, and staff supported people with these needs where required. However, daily records were not always completed, resulting in missing evidence of care being delivered. For example, a person’s records detailed them as requiring support from staff with preparation of their meals and drinks. However, daily records were not always completed by staff to evidence this was provided. This meant it was unclear whether they had received this support in line with their needs.

There was effective communication between care staff, people and their families which helped ensure people’s needs were generally understood and met. Staff shared relevant information appropriately and responded to changes in people’s conditions in a timely manner. However, care plans required improvement to better reflect people’s individual needs and to support staff and other professionals in appropriately assessing, planning, and delivering care, treatment, and support. For example, one person did not have a care plan in place to fully detail their health and wellbeing needs to ensure these were understood by staff and other professionals where required.

Most people managed their own healthcare needs with support from their families. Staff knew people well and were able to describe what actions they would take if someone required healthcare support. A person told us, “My carers know about me and my medical needs, when I need to go to hospital and they come to my appointments with me.” However, care plans lacked personalised detail to guide staff in understanding people’s specific healthcare needs or how to recognise signs that a person may be unwell, to ensure timely and appropriate responses to changes in people’s health. For example, a person’s records detailed them as having a life limiting illness. However, there was no detail of the symptoms they may experience and how this was to be managed and monitored by staff to ensure this was supported consistently and safely.

Systems to monitor and improve outcomes for people required further development. Whilst care staff were committed to providing good care and understood people’s day-to-day needs, leaders did not consistently review people’s outcomes to ensure these were positive and to drive improvements where required. This meant areas for improvement found at the inspection had not been identified by the provider. For example, records showed and staff confirmed a person was experiencing emotional distress due to the support they were receiving. The provider had not reviewed this to identify areas for improvement and ensure the persons was experiencing positive outcomes. Care plans and records did not reflect peoples individualised expectations and goals. This meant the provider was unable to effectively assess whether they were meeting these or not and to ensure continuous improvements were made to people’s care.

People's rights under the Mental Capacity Act (MCA) were not upheld. The registered manager and acting manager demonstrated a lack of understanding of the MCA and failed to ensure that restrictions placed on people were lawful and in line with the Act. There was no evidence that mental capacity assessments had been completed, nor that best interest decisions had been made where people may have lacked capacity. This failure to follow legal requirements meant that people were at risk of having their freedoms restricted without appropriate safeguards or consent.