New Partnerships Lynray and Peach Cottage

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 58 (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 was effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The provider assessed and reviewed people’s health, care, wellbeing and communication needs as part of care planning. However, care plans were not always clear, and staff were not always aware of the content and as a result, people were at risk of inconsistent care.

Relatives told us that the assessment and reviewing processes were inconsistent. Some relatives told us that they were involved in reviews, but others were not. One told us, “What tends to happen is we have a failure, which we will go to have a meeting about, so you're always reviewing something to overcome what's just happened or what's happening right now. So, I can't say we actually sit down annually and have a review meeting with them.”

The provider told us that they were planning to introduce regular meetings with both staff and relatives to review people’s needs and improve communication.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

We observed the provider had an awareness of national best practice models such as STOMP (stopping over medication of people with a learning disability, autism or both with psychotropic medicines). They also told us of the steps that they were taking to ensuring the risks around constipation were managed.

People were supported to participate in national screening programmes.

Efforts were made to integrate into the local community and staff supported people to maintain relationships which were important to them. For example, taking one person for a meal with their family member.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

People were supported to access services, and we saw evidence in care plans of consultation with a range of health professionals such as podiatry and psychiatry. People had had health action plans and hospital passports that detailed their medical needs as well as their communication needs.

However, the contents were not always understood, and we saw that when a person recently became unwell, and they were admitted to hospital, staff did not follow the providers procedures or their training to ensure a smooth transition.

Relatives expressed concern about communication and told us about an example where it had been agreed that a health professional would review a person at the service at an agreed time however a member of staff had taken the person off site, so they were not there when the professional had visited. Relatives told us they were not always kept up to date or staff did not always follow what had been agreed. One relative told us, “I arrange and get involved with all of (my relatives) medical appointments, because I have found when staff take them, the feedback is zero.”

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 supported to attend routine appointments and efforts were made to motivate people to exercise and access their local community. Some people had regular commitments such as work placements.

Concerns had previously been raised about the meals provided and a focus on eating out rather than on home cooked meals. We saw that people were going out for meals, but we also observed that fresh ingredients were available for cooking meals at home. The manager told us that they were working with staff on meal planning and there was a renewed focus on healthy eating. Food shopping was coordinated by senior staff to ensure closer monitoring. Staff told us the manager was planning to take pictures of food to guide staff on how food should be presented.

One relative told us that they had been working with the home on healthy eating and they had started to see some improvements and health benefits as their family member’s blood sugar had reduced.

The provider did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Peoples care was routinely monitored, for example people’s weights were taken regularly and there was bowel monitoring where people were at risk of constipation. Efforts were made to integrate people into the community and live in a healthy way.

Relatives told us that their family members basic needs were met however expressed concerns about the skills of staff and a lack of consistency and imagination which meant that outcomes for their family member was not as good as they could be and had deteriorated with this provider.

The provider told people about their rights around consent and people had their capacity assessed and where required deprivation of liberty safeguards (DoLS) authorisations were applied for. Staff had received training in mental capacity and could tell us how they offered people choices and gained consent. However, some staff lacked understanding of more complex decision making and best interest decisions. A recent incident had occurred which had also highlighted gaps in staff knowledge regarding capacity and understanding of procedure. The provider told us that they planned to take action to build on staff skills and competency.