CSS Care Ltd

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. For this key question we assessed the quality statements relating to; assessing needs, monitoring and improving outcomes and consent to care and treatment. We identified 1 breach of the legal regulations. The provider failed to ensure people’s needs were fully assessed; and accurate, complete and contemporaneous records were kept. Care records had significant gaps; information did not fully reflect people’s needs and we saw evidence people were not always receiving the agreed level of support. However, we did review a recently updated care plan which evidenced the positive steps the provider was taking to ensure care records were more robust. Whilst we received some positive feedback from people around good outcomes and staff seeking consent, systems and processes were not fully embedded in these areas.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People confirmed they were involved in the assessment of their needs and most told us their care needs had been reviewed at some point. However, not everyone had a care plan in their home for staff to refer to, and we received feedback that staff did not always fully understand people’s needs. This impacted the effectiveness of their care and treatment. One person told us, “[Staff] don’t know my needs, they don’t know about me before they come.”

The manager acknowledged assessments were not up-to-date or fully reflective of people’s needs. We received mixed responses from staff about their awareness of people’s care plans and whether they had enough time to read information about people’s health, care, well-being and communication needs.

Processes to assess and record people’s care needs were not robust. Information was not always thorough, and some people’s care plans were inaccurate. For example: a care plan we reviewed stated the person needed support with personal care, but staff confirmed this was not the case. New and unfamiliar staff did not always have access to detailed, person-centred guidance; meaning the provider could not ensure people received care or treatment in line with their needs or preferences. Records reviewed indicated staff were not always staying for the agreed duration, so we could not be assured people’s assessed needs were being met.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

Feedback about people’s outcomes was mixed. One relative said, “My relative can shower themselves now which is thanks to the hard work of staff. Before, they had to have 2 carers but with risks safely managed, they have some independence and dignity back.” However, a person using the service told us care and treatment had not always met their expectations, and the service had made little attempt to improve their outcomes.

There was little feedback from staff and managers about promoting positive outcomes, though from conversations elsewhere it was apparent there was limited focus on continuous improvement throughout the service.

There was a lack of effective approaches to monitor and improve people’s care and treatment, meaning people did not consistently experience positive outcomes. Care plans and risk assessments were not reviewed following a change in needs, and we saw no evidence people or relatives were involved in reviews of care or treatment.

People and relatives confirmed their views and wishes were taken into account when care was planned and told us staff sought consent prior to care and treatment.

Not all staff understood the concept of obtaining consent before they delivered care or treatment due to language barriers. However, those staff who did understand confirmed they sought consent from people. One staff member said, “Consent, this is really important. I always tell people what I am doing so they are first prepared.”

Systems and practices to ensure people understood their rights around consent were not embedded. Consent forms were not consistently completed, and some forms were signed by relatives despite there being no evidence the person lacked capacity to act on their own behalf.