Cherry Care Services Limited - Northampton

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 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.

The service carried out assessments to ensure people’s needs could be identified and understood before care commenced. We saw evidence of pre-admission assessments which considered people's health, care and support needs, including their ability to be involved in decisions about their care. Where people required support to participate in the assessment process, this was documented.

Staff told us the registered manager undertook assessments with people wherever possible to ensure their views, preferences and desired outcomes were understood. Staff also explained that relatives and advocates were involved when people were unable to express their views independently, helping to ensure important information about people's needs and wishes was gathered. One person confirmed their involvement in the process, saying, “Yes, I was there at the meetings.”

The assessment process supported the provider to plan care that reflected people's individual circumstances and needs. We saw evidence that relevant information was considered prior to people receiving support, helping to ensure care could be delivered safely and effectively from the outset.

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.

The service used recognised tools and guidance to support the delivery of effective, evidence-based care and treatment. We saw evidence that nationally recognised assessment tools were being used, including the Malnutrition Universal Screening Tool (MUST), to identify and monitor risks relating to people's nutritional needs. This helped to ensure people received appropriate support and that risks to their health and wellbeing were identified and responded to in a timely way.

Assessments and care planning considered people's individual needs and were informed by recognised approaches to care delivery. Staff were able to describe how they used information within care records to support people in line with their assessed needs and preferences.

We found the provider had systems in place to support the delivery of care based on current good practice. There was no evidence that people had experienced poor outcomes because of care and treatment practices, and people told us they were satisfied with the support they received. This demonstrated that people's care was planned and delivered using recognised standards and evidence-based approaches.

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.

Staff told us that communication within the service was effective and that important information about people’s needs, risks and wellbeing was shared appropriately between team members. One staff member said, “We all communicate well.” This helped to ensure staff had access to the information they needed to provide consistent and coordinated care.

People told us they were supported to attend healthcare appointments, including hospital appointments, when required. This helped to ensure they could access the healthcare services they needed and that any changes to their health were identified and responded to appropriately.

Staff described positive working relationships within the team and with external professionals involved in people’s care. This supported a joined-up approach to care delivery and helped to promote positive outcomes for people. We saw no evidence that poor communication or a lack of coordination between staff and services had negatively impacted people’s care or wellbeing.

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.

Staff understood the importance of promoting healthy lifestyles and supporting people to access healthcare services when needed. People told us they received the support they required to manage their health and attend appointments.

Care records demonstrated that people's health needs were considered as part of their care planning, and staff worked with people to promote their wellbeing and independence. Where necessary, people were supported to access advice and treatment from healthcare professionals. One person told us, “I need quite a lot of help when I go out because I use a wheelchair. When I go to the hospital I have a [staff member] with me.”

We did not identify any concerns in relation to this quality statement. People spoke positively about the support they received, and there was no evidence that people were experiencing unmet health needs. This demonstrated that the service supported people to live healthier lives and maintain their wellbeing.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Care plans clearly identified the outcomes or goals people wished to achieve, and we saw evidence these were reviewed regularly. This helped staff to monitor people's progress and consider whether care and support continued to meet their needs.

However, there was limited evidence that people and those important to them had been involved in reviewing these outcomes and assessing whether the support provided was working for them. Whilst reviews had taken place, records did not consistently demonstrate that people's views, experiences and feedback had been sought and used to evaluate the effectiveness of their care. This meant the provider could not always demonstrate that care remained focused on achieving outcomes that were meaningful to people.

Despite this, we did not identify evidence that people were experiencing poor outcomes because of the concerns identified. Care plans remained up to date and reflected people's current needs. However, without consistently involving people and, where appropriate, their families or representatives in reviewing care and support, the provider could not be assured that people's views were fully informing decisions about how outcomes were monitored and improved.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

People told us they were asked for consent during day-to-day support from staff. One person said, “Yes, they ask for consent. I need quite a lot of help.” However, we identified shortfalls in documentation relating to consent.

Whilst we saw evidence that mental capacity assessments had been completed for some decisions, assessments had not been carried out for all decisions where there was reason to believe a person may lack capacity. For example, there was no evidence of a mental capacity assessment relating to the use of a wheelchair lap belt, despite this being a restrictive intervention requiring consent or lawful decision-making.

Where mental capacity assessments had been completed, the records lacked sufficient detail to demonstrate how the assessment had been carried out. Assessments were largely based on yes/no responses, and the free text provided was often identical across assessments relating to different decisions. This meant the provider could not demonstrate how the person's ability to understand, retain, weigh up and communicate information had been considered for each specific decision. Records also did not clearly evidence what steps had been taken to support and enable people to participate in the decision-making process.

Best interest decision records were similarly limited in detail. These records consisted primarily of ‘yes or no’ responses and did not clearly document the decision that had been agreed, the options considered, or how the decision was determined to be in the person's best interests. As a result, the provider could not demonstrate that best interest decisions were being made and recorded in line with the MCA Code of Practice.

Despite these concerns, people told us that staff sought their consent before providing support and involved them in day-to-day decisions about their care. We did not identify evidence that people had experienced harm as a result of the issues identified. However, the lack of robust and decision-specific mental capacity assessments and best interest records meant the provider could not consistently demonstrate that people's rights were being protected and that decisions were being made lawfully on their behalf when they lacked capacity to consent.