The Bungalow

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.
 

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, wellbeing and communication needs with them.

Although people’s needs were assessed before they began using the service, the provider did not consistently assess and review people's changing needs. For example, one person’s care plans had not been sufficiently updated following significant change in their support needs. Some people’s documentation contained conflicting information regarding communication methods and activities, making it unclear whether care planning reflected current needs and preferences.
 

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

People were not always supported in line with Positive Behaviour Support (PBS) principles or the expectations of Right support, right care, right culture.

While the provider had adopted recognised behavioural support approaches, there was insufficient evaluation of their effectiveness when incidents continued to occur.
 

The provider did not always work well across teams and services to support people.

Staff did not always have access to consistent and accurate information to support people safely. Information about people's care and support was recorded across multiple systems and documents, and staff were not always able to identify current records. This reduced assurance that people received coordinated and consistent care.
 

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Opportunities to promote healthier lifestyles were limited as not all people were consistently supported to maintain healthy lifestyles and wellbeing. Oversight of dietary support was ineffective, and records showed one person was frequently offered a repetitive diet consisting mainly of processed foods despite guidance to promote a healthy and balanced diet.

Opportunities to engage in meaningful activities were limited. We saw one person’s care plans had not been sufficiently updated following a change in their health needs. Although, the need to support the person to discover new activities had been identified, records showed the person was offered limited activities and often declined the activities they were offered. As a result, they took part in limited activities, spending most of their time during their stay in the house doing the same things.’

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.

Systems for monitoring and improving outcomes were not consistently effective. Records showed care plans had not always been reviewed and updated to reflect changes in people's needs. The provider had not identified or addressed inconsistencies in communication support, despite records showing agreed communication tools were not being used in practice. This meant opportunities to evaluate the effectiveness of support and improve outcomes for people were missed.

The provider did not consistently monitor whether support was achieving positive outcomes for people. Records largely reflected routine care activities, with limited consideration of individual goals, aspirations or progression towards greater independence.
 

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

Systems to support lawful decision-making were not always effective. MCA processes were in place but not always aligned with current requirements. The provider was using an outdated mental capacity assessment format and had not kept up to date with changes in the application of the Mental Capacity Act 2005. This reduced assurance that decisions about people's care and treatment were being supported in line with current requirements Communication support was not always used to enable informed decision-making.