Sugarman Health and Wellbeing - Watford

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

This service scored 63 (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 assessed and reviewed people’s health, care, wellbeing and communication needs with them. Their process for new referrals included a risk assessment completed by the provider’s national team. This had prompts to escalate to the clinical lead and quality team, dependent on level of risk, to determine any additional training requirements, for example. It was then sent to the implementation team to arrange resources. A nurse care manager or implementation co-ordinator then visited people to assess and agree their needs and created the care record. We saw these included the person’s physical and mental health needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. People’s care plans included details about support with food and drink. This included whether people were able to eat independently and any special diets, allergies and preferences. A family member described specific support needs their relative had and told us, “Carers do always ask what [person] wants to eat…their help with this is vital.”

The provider did not always work well across teams to support people. Care staff described issues with communication with the office. A staff member said, “We never receive any updates on anything. We as carers have to email over and over again to get any answers.”

People’s relatives also described issues with communication with the office team. We were told, “They tend to say they’ll do things but don’t follow things through.” Another family member said, “They are often quite hard to contact.” However, staff confirmed there were handovers between shifts and 1 staff member told us, “I feel supported by the company all the time when I need help.”

People were supported to access other services as required. Their records included contact details for other professionals involved with their care.

The provider routinely monitored people’s care and treatment. The timeframe for care reviews was annually or with a change in need. However, given the complex nature of people’s needs a more frequent review may have identified some of the gaps we found in people’s records to ensure people’s clinical expectations were met.

The provider did not always work within the principles of the mental capacity act. 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 Act requires that, 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. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty.

People’s care records stated whether they had capacity to consent to care. This included where decisions they made were putting them at risk and they understood the potential consequences.

Some people were monitored constantly or checked regularly. The registered manager told us most people had capacity to consent to this. We reviewed the record for a person who lacked capacity to consent to care who was closely monitored by staff. We found a capacity assessment had been completed which stated they were not subject to constant supervision, which was not correct. This meant the next step in the process was not completed so the principles of the mental capacity act were not followed. We fed this back to the registered manager, and they told us they would review this with the nurse care manager.