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 continued breach of legal regulation in relation to consent to care.

This service scored 42 (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. The provider and care staff demonstrated an understanding of people’s needs. However, care plan guidance for staff, which outlined people’s individual care and support needs, lacked personalised information and updates were not consistently made when people’s support needs changed. Whilst staff knew people well, there was a risk that unfamiliar or temporary staff would not know how to support people safely and effectively due to the lack of information provided. For example, staff told us 1 person used a nebuliser, but this was not documented anywhere in their assessment or care plan.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. The provider 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 staff supported people with these needs where required. However, care planning documentation lacked sufficient detail on how to support people with these needs. For example, despite documented swallowing difficulties and reflux for one 1 person, the care plan did not detail techniques, positioning guidance, or risk reduction strategies that reflect recognised best practice.

There was effective day to day communication between staff, people using the service and their families. This supported staff to understand people’s needs and respond promptly when their condition changed. However, we identified occasions where the provider made clinical decisions and carried out clinical interventions without seeking advice or input from relevant healthcare professionals. This meant people did not always benefit from appropriate clinical oversight, and it demonstrated gaps in how the service worked with external professionals to ensure safe and coordinated care.

People were supported to manage their health and wellbeing with the support from their families and where required, care staff supported people to schedule and attend health appointments. A person said, “They understand my individual health needs and how they affect me daily.” A relative told us, “There’s been many instances of [person] being unwell. [The provider] has got in touch with me, made me aware of it and said he will be contacting healthcare professionals.” Despite this, further engagement was required with health care professionals to ensure the support and responses by staff were appropriate in ensuring people’s health and wellbeing needs, for example, when supporting with catheter care.

The provider did not always ensure people’s outcomes were effectively monitored. Although risks were recorded, the provider did not consistently act on them or any emerging concerns to improve outcomes for people. For example, a person experienced repeated medication issues, including missed or poorly recorded applications of creams. However, no clear action was taken to prevent these problems happening again. Another person’s care plan recorded them as wanting to go out into the community more but felt too frightened because of their risk of falling. Despite this being known, there was no evidence of any referral, support plan update, or action to help the person safely work towards this goal. This shows that while information was recorded, it was not used effectively to improve people’s safety and outcomes.

Since the last inspection, the provider and staff had completed online mental capacity training, and the provider was beginning to receive additional support from an external consultant to improve their understanding of the Mental Capacity Act (MCA). However, there remained no evidence that mental capacity assessments were being carried out, or that best-interest decisions were being made for people who may lack capacity. This ongoing failure to follow legal requirements meant that people continued to be at risk of receiving care without valid consent and of having their rights and freedoms restricted without the necessary safeguards.