Danescourt

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 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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.
Staff knew people well and considered people’s physical, mental health, communication and social needs, however, we found that care records were not in place or were conflicting or not always clear what actions had been taken to ensure people’s needs were being met. For a person who was at risk of skin breakdown there was appropriate involvement from health professionals but there was no care records in place or information to guide staff on how to effectively provide support in this area. Care records were not consistently kept up to date, despite regular reviews, and some contained outdated or contradictory information. Staff reported issues with the recording system, including records failing to save, which impacted the accuracy and reliability of documentation.
 

The provider involved people in planning and delivering their care and treatment, including what was important to them, in line with legislation and current best practice.
Care records included personal details such as preferences, likes, dislikes, and goals. People told us they were offered choice, including around activities and meals. Mealtimes were positive, with people actively involved in buying, preparing and cooking food.
Weights were monitored where required, and a range of professional assessments had been completed to support people’s needs. Staff told us they were kept up to date with people’s needs via handovers and staff meetings; however, the provider had not ensured all care records and risk assessments reflected this.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing assessments when people moved between services. Plans for transition, referral, and discharge considered people’s individual circumstances, ongoing care arrangements, and expected outcomes.
People were supported to attend appointments with professionals, which promoted coordinated care. Records showed people accessed a range of health and social care professionals, such as GPs, and where required regular multi-disciplinary meetings took place.
 

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 communicated effectively with people, offering reassurance, choice, and support. People were encouraged to be healthy and maintain independence within the home. We saw that people were actively going out to take part in different activities.

People were supported to attend their annual health check ups, and staff worked with external healthcare professionals to ensure appointments were arranged and followed up.
 

Systems to support outcomes were in place but monitoring and recording of outcomes were inconsistent and did not provide clear evidence that people were achieving positive results. One person had a diagnosis of dementia, and staff reported confusion and reduced capacity however, this was not recorded in care records. This meant there was no clear monitoring of how their condition was progressing or how support should adapt. Another person had a behaviour support plan, but it did not include clear guidance on communication strategies or when to use alternative approaches, such as PRN medicines. This limited staff’s ability to monitor whether interventions were effective.

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

There was no information to demonstrate people’s capacity to consent to care and treatment had been assessed in line with the MCA. Care records and staff feedback indicated that some people lacked capacity; however, during the inspection, leaders stated all people had capacity to consent and advised that no records were required regarding consent or capacity.
No mental capacity assessments or best interest decision records were shared to evidence people’s ability to consent had been considered, or that any restrictions in place were lawful and in their best interests. This meant the provider could not demonstrate they were working in line with the MCA or ensuring decisions were made appropriately for people who may lack capacity.