Crimson Manor

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

The service did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care and wellbeing needs with them. We looked at 5 care plans people’s needs were not always clearly assessed, this meant staff did not always have clear guidance on people’s current needs. For example, we observed staff providing support to a person cared for in bed due to person’s deterioration in health and needs although this information had not been recorded within the persons care plan. Care records lacked detail of support provided and this made it difficult to ascertain if care provided was in as assessed within care plans and people’s needs were being met.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. The registered manager told us they used evidence based practise to support communication, nutrition and mealtimes, pain management and activities. Whilst there was recognised good practise around meal planning, we found overall all these tools were not implemented effectively or consistently.We looked at 5 care plans and they all had a recent review date recorded. However, we found no recorded evidence of any involvement from the person or relatives in the recently completed reviews. We received feedback from health partners. One partner told us, “Our team feel that staff lack knowledge for a person with a complex diagnosis, staff do not ask open questions to the person to find out how they are feeling. Their documentation is poor on describing what the person is experiencing.” Professionals involved in the care and support of people told us they found communication from the service can be poor. One professional said, “Staff rely on an online system which is not always adequately documented on, staff seem disinterested towards visiting professionals.”

The service did not always work well across teams and services to support people. One person had recently returned to the service after a stay in hospital. We found the service had not followed advice on the discharge summary for the person on discharge relating to medicines. The service had not identified the issue and only actioned the advice when prompted by the inspector. During our assessment we found the management team were not forthcoming with providing requested assurances and information. When we shared our concerns, we did not always receive assurances that effective action would be taken. For example, we observed and shared concerns regarding staff competencies for moving and handling, the registered manager discussed these concerns with the staff and told us staff did not agree with our observations and that after discussions with staff felt they had the relevant competencies and training. We received no further assurances that their practice would be assessed.

The service supported people to live healthier lives and where possible, reduce their future needs for care and support. All people living at the service was registered with a local GP surgery and they completed regularly visits to the service. The service had a chiropodist, and we saw evidence they visited the service regularly. The service displayed a food for life certificate gold award. This is a program that helps provide healthy, sustainable and tasty food. The cook told us the service used electronic recipe management software to ensure food met people’s specific dietary needs.

The service did not always routinely monitor people’s care and treatment to continuously improve it. We found when reviewing people’s care plans, they had inconsistent and inaccurate information recorded. For example, we observed and reviewed recorded support provided by staff that was not consistent with support recorded as required in care plans and this included personal care, movement and handling support and equipment used by staff and information relating to specific dietary needs. These discrepancies were not identified during monitoring by the service.

The service did not always seek consent from people when delivering care and treatment. We saw staff did not always offer choices to people about how they would like their care to be provided. We also saw staff had not always recorded any choices offered to people around meals, personal care and activities. However, staff did on occasion record that people had declined support. Deprivation of liberty safeguards were in place or applied for by the service for people requiring them. Care plans recorded information around people’s capacity and best interests. This guided staff on what decisions people were able to make.