Cosford 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 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.

Staff assessed and reviewed people’s health, care, wellbeing and communication needs, and relatives told us these reflected long‑term and complex needs. People had detailed histories, including condition‑specific information, and staff worked with community professionals to respond to changing needs. Relatives told us assessments and reviews reflected people’s long term and complex needs. A family member explained, “[Name] is doing really well considering after lifelong mental health problems, he feels well looked after and very secure now.”

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.

People received care and support that reflected current good practice for their health conditions, although some written plans did not yet fully describe the approaches staff were using. Staff worked closely with community mental health teams, Parkinson’s nurses, occupational therapists and other health professionals, adapted medicines when side effects affected mobility or mood, and used root cause analysis and falls clinic referrals when incidents occurred. People took part in structured exercise groups, work link placements and tailored activities, and staff used health monitoring tools such as body mass index, nutritional scores and skin assessments to inform care.

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, managers and external professionals worked well together so people experienced coordinated care. The team had regular handovers, clear to-do lists, and staff described open communication with managers through supervisions, staff meetings, and a WhatsApp group, which helped them stay updated on people’s needs and service changes. The service had strong links with community providers. One staff member told us, “We try and work as a team as much as we can, we handover, log on the devices, then we can flag it for handover.”

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 live healthier, more active lives and to pursue their interests, with a strong focus on independence and community involvement. Staff enabled people to attend boxing and fitness classes, walking groups, holidays and day trips, and to access health appointments such as X‑rays, blood tests and specialist clinics. People were supported to learn or maintain daily living skills, including cooking, budgeting and travel, and some were encouraged to apply for work or attend work‑link schemes, which promoted confidence and motivation. Staff used these opportunities to support people’s mobility, emotional wellbeing and independence. One relative told us, “[Name] does boxing and goes to shows quite regularly. He went to London for the weekend and saw The Lion King. He loved it.” Records showed people had access to health services and lifestyle support.

The provider did not always routinely monitor people’s care and treatment effectively. They did not always ensure that outcomes were consistent, or that they met expectations.

Governance systems were not yet fully embedded or always effective to give consistent assurance that outcomes were monitored and analysed for all aspects of care. However, the service had systems under development to monitor and improve outcomes, including a detailed service improvement plan, clinical and environmental audits, medication audits and root cause analyses following incidents such as falls. Staff completed daily logs, food and fluid charts, behaviour and health records, and used structured tools, as well as incident reviews. There was a clear commitment and momentum for improvement, evidenced by the provider’s service improvement plan.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, these were not always documented effectively.

People were usually involved in decisions about their care, and consent forms were in place for areas such as care and treatment, medicines, media and personal care. Relatives told us they were invited to reviews and kept informed about changes, including for people with long‑term placements and complex health needs. One relative said, “I’m invited to reviews and [Name] comments on things because they take his views into account.”

However, documentation did not consistently show how staff supported people with more complex decision making. This had been identified as an area for improvement within the service improvement plan.