Peter House

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 inspection we rated this key question requires improvement. At this inspection 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 provider was in breach of the legal regulations in relation to people’s 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.

The provider did not always make sure people’s care and support was effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. The provider had completed an initial assessment of people’s needs. However, this information was not always sufficiently detailed. Assessments did not always provide a comprehensive view of people’s health, care, wellbeing and communication needs. There was a lack of evidence to demonstrate how people and those important to them were involved in assessing and reviewing the care provided. This meant it was not clear how people’s views and opinions were captured, respected, listened to and implemented as part of the day-to-day support.

The provider did not always plan and deliver people’s care and support with them, including what was important and mattered to them. People’s care was not consistently delivered in line with ‘Right support, right care, right culture’ guidelines. For example, people’s care records did not always evidence person-centred care planning or demonstrate how people were supported to engage in activities which were meaningful and important to them. The provider did not demonstrate a focus on reducing restrictive practices to improve people’s quality of life.

The provider did not always work proactively with teams and services to support people’s changing needs. Information and updates relating to incidents and restrictions were not always shared promptly with relevant health professionals. The provider was not always able to demonstrate they had acted on all relevant recommendations from health professionals to ensure people had the right measures in place to minimise restrictions and risks.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. For example, people’s care plans did not always contain sufficient detail about how to promote people’s choice or involve them in making decisions about their health and wellbeing. The provider was not always able to demonstrate how incidents relating to people’s emotional support needs were monitored and reviewed to ensure any deterioration in their health or wellbeing was promptly identified and acted upon.

We received mixed feedback about how well the provider communicated with people’s relatives to ensure they were involved in discussions about people’s changing health needs where appropriate.
 

The provider was not able to demonstrate how they involved people and their relatives in regularly monitoring their care and support in order to improve it.

People’s care plans did not evidence how they were being supported to identify what was important to them or plan future goals and aspirations. The provider did not robustly analyse information relating to restrictions in people’s lives. This meant it was not clear how they were exploring reducing restrictions or improving outcomes.

The provider had not acted in accordance with the requirements of the Mental Capacity Act 2005 and the associated code of practice. At the time of the inspection, people did not have decision specific capacity assessments in place for all relevant decisions. This meant the provider was not able to demonstrate how they had considered people’s capacity to consent or supported them to make their own decisions about their care.

People had DoLS (Deprivation of Liberty Safeguards) in place. However, these did not always accurately reflect the restrictions in people’s care. The provider had not ensured the conditions listed on people’s DoLS were followed. For example, 1 person’s DoLS had a condition detailing mental capacity assessments must be in place. At the time of the inspection, these were not in place.