Clover Healthcare

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.

This is the first assessment for this service. This key question has been rated good.

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

This service scored 67 (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 needs were assessed before they began receiving care, and further assessments took place when their circumstances changed. Staff gathered relevant information from people, their families and other professionals to ensure assessments were accurate and reflected people’s current needs. This helped staff understand what mattered to people and how to support them safely.

Whilst assessments were completed and care plans were in place, some people’s care plans would benefit from more person-centred detail. In certain cases, information describing people’s preferences, routines or what was important to them was limited. This did not affect people’s safety or outcomes, but more personalised detail would strengthen the plans and better reflect the individualised support staff described providing in practice.

Overall, the assessment process was effective, and staff understood people’s needs well. Strengthening the person-centred detail within care plans would further improve how clearly people’s choices, preferences and what mattered to them were reflected in written records.

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

During the assessment, we reviewed four people’s care plans. Only one contained a completed Waterlow pressure area risk assessment, and there were no Malnutrition Universal Screening Tool (MUST) assessments seen. It was not always clear from the documentation whether these tools had been used elsewhere or whether people were considered at risk of malnutrition. The absence of these tools meant the provider could not consistently demonstrate that clinical risks relating to skin integrity or nutrition had been assessed in line with best practice.

Despite these gaps in documentation, there was no evidence that people had been harmed as a result. Staff understood people’s day-today needs well, and relatives told us they were confident in the care provided. One relative of a person with a catheter told us staff regularly reminded the person to drink water to help reduce the risk of the catheter becoming blocked. This showed staff were aware of practical health-related risks and took proactive steps to reduce them, even though such actions were not always recorded in care plans.

However, without consistently completed evidence-based assessment tools, the provider could not fully demonstrate that health-related risks were proactively identified, reviewed or monitored. Improvements were needed to ensure appropriate clinical screening tools, such as Waterlow and MUST, were used routinely and documented clearly. This would help strengthen the provider’s ability to evidence safe, effective and preventative care and ensure decision-making is supported by robust assessment information.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

There was evidence of effective partnership working, including a clear and well-managed referral process. The service had been approved on a local authority commissioning panel, which demonstrated that commissioners had confidence in its systems, governance and ability to work collaboratively with external professionals.

Staff described positive teamwork and said they felt supported by colleagues and leaders. They told us communication within the team was strong, information was shared appropriately, and they could easily seek advice when needed. This helped to ensure continuity of care, particularly when people’s needs changed or when support required coordination with other services.

There had recently been a change in leadership at the service. Despite this transition, the team had remained strong, cohesive and focused on delivering good-quality care. Staff told us the change had been managed well, and they continued to feel listened to and supported by managers. This stability and resilience within the team helped maintain consistency for people using the service and ensured staff continued to work effectively together during the period of change.

Leaders promoted a supportive culture where staff felt listened to and well guided. This contributed to a cohesive approach to care delivery, helping ensure people experienced joined-up, consistent support across staff, teams and external partners.

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.

People were encouraged to make healthy lifestyle choices as part of their day-to-day support. For example, staff reminded people to drink plenty of water and helped them understand the importance of good hydration. A relative of one person told us staff regularly encouraged the individual to drink more water, which helped reduce the risk of health complications and promoted their overall wellbeing.

One person living in supported living had a list of activities they enjoyed and a weekly activity planner. This was used to encourage gentle exercise, maintain structure and help prevent isolation. Staff used this plan to prompt and support the person to stay active and engaged in meaningful routines that contributed positively to their physical and emotional health.

Staff understood people’s needs well and supported them in a way that was proactive, personalised and aligned with what mattered to them. This helped people maintain healthier lifestyles, stay connected with others and remain as independent as possible.

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.

Relatives told us that care plans were updated when there had been changes in people’s needs. One relative told us, “[Person’s] care has been reviewed a couple of times. The level of support has reduced because it was no longer needed.” This demonstrated that the provider responded to people’s changing circumstances and ensured support remained appropriate.

Staff and leaders told us that care plans were reviewed regularly with people to ensure they remained up to date and reflective of their changing needs. One staff member told us, “We send assessment forms to clients to see if they’re happy. Quarterly the senior staff will do a care plan review.”

However, care plans were only signed and dated by the registered manager, and there was limited documented evidence of people’s involvement in these reviews. While people were verbally consulted, the absence of recorded participation reduced the provider’s ability to fully evidence a person-centred and co-produced approach. Despite this, staff understood people’s needs well, and the updates made to plans showed that the service acted on new information in a timely and effective way. People and relative felt confident that changes were communicated clearly and reflected accurately in the support provided.

Overall, outcomes for people were positive, and the systems in place supported continuous improvement. Strengthening the documentation of people’s involvement in reviews would further enhance the provider’s ability to demonstrate a fully person-centred and collaborative approach to monitoring care.

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 we spoke with were able to clearly describe how they gained consent from people when delivering care. They explained how they checked people’s agreement before providing support, how they responded if someone refused care, and when they would escalate concerns to senior staff. One staff member said, “I explain what I’m doing, check if they agree and respect their choices.” This demonstrated that staff understood the principles of consent in practice and were committed to ensuring people remained in control of their day-to-day care.

However, the documentation did not support good practice. While we saw evidence that initial assessments were signed and consented to, there was no documented evidence that people had consented to their care plans. Care plans were not consistently signed by the person or their representative, which meant the provider could not demonstrate that people had agreed to the support being delivered.

Where a person might not have had the mental capacity to consent to their care plan, mental capacity assessments were not clear, sufficiently evidenced or specific to the decision being made. Some assessments did not clearly outline the decision in question, the steps taken to assess capacity, or the information provided to the person to support their understanding. In the cases where individuals were assessed as lacking capacity, there was no documented evidence of best interest decisions being completed, or of these decisions involving the right people.

These gaps in consent related documentation meant the provider could not always evidence that decisions were lawful, person centred or compliant with the Mental Capacity Act (MCA). While we found no evidence that people had been harmed, the lack of clear records increased the risk of inconsistent or noncompliant practice.

Improvements were required to ensure consent is clearly recorded, mental capacity assessments are decision specific and well evidenced, and best interest decisions are completed and documented where required. Strengthening these processes will help ensure people’s rights, choices and freedoms are consistently upheld.