Pleasant Valley Care Shropshire Branch

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.

This is the first assessment for this newly registered service. This key question has been rated 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 were effective because they did not always assess and discuss people’s health, care, wellbeing and communication needs with them consistently.

People’s needs were assessed prior to receiving support, and a person-centred approach was demonstrated. Assessments covered a range of areas, including people’s physical, emotional and social needs. However, the level of detail and quality of information varied across records. Some assessments lacked sufficient detail to fully guide staff in delivering consistently safe and effective care.

Although assessments were reviewed and updated when people’s needs changed, the inconsistencies in how information was recorded meant there was a risk staff may not always have access to clear and comprehensive guidance. This did not support a consistently well-informed or coordinated approach to care delivery.

The registered manager acknowledged all assessments had not been completed in full and to the standard they would like and had identified this as an action for them to address. The registered manager showed us an assessment that had been completed to the standard they were aiming for. This was comprehensive and provided a clear and holistic picture of the individual’s needs which would have fully guided staff how to deliver care to them.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, they could not always be assured this was done in line with legislation and current evidence based good practice and standards due to gaps in staff training.

Staff knowledge of evidence-based care was variable, and not all staff had received appropriate or current training to support them in delivering care in line with best practice standards. Whilst people provided positive feedback regarding the care received, this meant care delivery was sometimes based on routine or custom rather than informed, up-to-date guidance. In addition, oversight systems to monitor the quality and effectiveness of care were not sufficiently robust to identify and address gaps. As a result, the service could not be assured people consistently received safe, effective, and high-quality care based on the best available evidence.

Despite this lack of assurance, daily records contained detailed and thorough information which showed people were receiving appropriate support that met their assessed needs and focused on what mattered to them.

The provider did not always work well across teams and services to support people. The provider did not always share information openly with other agencies.

The provider had not been fully open and transparent during the assessment process, which limited our assurance information shared about people’s care and partnership working was accurate and complete. This lack of transparency and oversight meant the provider could not demonstrate how joint working arrangements consistently supported safe and effective outcomes for people.

Although there were some systems in place to communicate with external professionals, these were not consistently effective, as records were informal and dialogue with professionals was not always recorded so they were not always available to demonstrate information was shared in a timely or robust way.

However, where people had planned care with health professionals, the provider worked alongside them and other agencies to ensure people received the support they needed. Where one person required additional support from a health professional, the provider met with them at a care call to take advice and ensure they could deliver care in the way the person needed it.

Communication between the registered manager, care staff and office staff was timely and effective. Staff told us they received important information as they were unable to progress with a care call without reading the previous call’s notes and they also used a staff email inbox where information was shared in a timely manner.

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 actively encouraged to make healthy choices about their diet. Staff provided appropriate prompts and encouragement to support people with personal hygiene and taking their medicines, which promoted healthy living.

Staff worked proactively with healthcare professionals, including GPs and therapists, to ensure people received appropriate support and timely interventions when their health needs changed. We saw examples of the provider engaging in training with clinical staff and where they had followed district nurse guidance to ensure they could meet people’s needs effectively.

People and relatives felt the support from the provider helped them to live healthier lives. One relative told us the registered manager had engaged with a GP about the person’s health and had contacted an ambulance. The relative told us, “The registered manager will stay over for longer time if needed for the person’s health. The registered manager stayed longer until the ambulance went with him, they’re so caring like that”.

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.

The provider did not monitor staff performance and practice through supervision or spot checks which meant they could not be assured they were supporting accountability and learning.

Information collected about people’s care was not always analysed in a structured way to evaluate effectiveness or identify areas for improvement.

The provider did not always actively seek feedback from people and professionals to ensure they were able to improve outcomes for people.

Despite this, people told us the care they received supported them to achieve positive outcomes and met their expectations. Where people had formal progress reviews, areas for improvement had been identified and actions were implemented to address this. However, these progress reviews were not always undertaken consistently to ensure outcomes were always measured for all people supported by the provider.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us they were asked for consent prior to care being delivered and daily logs evidenced staff asking for consent. Staff understood the importance of asking people for their consent to care. One staff member told us, “I ask for consent for everything to do with personal care or when it comes to dignity.”

People were required to complete consent forms prior to the commencement of the care package to ensure they understood how care would be delivered.

People’s capacity to make specific decisions was considered within their care documentation to ensure their rights were being respected. Whilst full care documentation was not in place for all people supported by the provider, people’s capacity to make decisions was considered within the basic initial assessment undertaken for all people prior to the commencement of care.