Boldshaves Oast

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• 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

Staff had a good understanding of people’s assessed needs including their physical, social and emotional needs and preferences. Staff understood how people communicated through speech and body language but this information was not always up to date in people’s records. Staff supported people to have maximum choice and control of their lives and staff supported people in the least restrictive way possible. However, some records and processes did not follow best practice.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us that staff knew them well and talked to them regularly about their care needs. People knew there were records about their care which they could see if they wanted to. Relatives said they were involved in their family members care. They told us they were consulted about people’s care needs and involved in reviews of their care. One relative told us, “It's very much a partnership approach and it works very well”. Another relative said, “She just gets amazing care.”

Staff were knowledgeable about people’s care and support needs. They were able to describe people’s preferred routines, the support people needed with their physical and emotional well-being and the best ways to communicate with them. Staff understood that people’s needs could change and the importance of communicating these changes to ensure the consistency of care provided.

Assessments had not consistently been kept up to date to ensure staff had access to guidance about everyone’s current care needs. The provider had been transferring care records from paper records to electronic records for over a year and had not completed this process. Staff did not have access to one person’s full care records. This was rectified during our assessment. In addition important information about how best to communicate with people was not available to staff or was not current. This included communication passports and tools to guide staff about how people who had limited or no verbal communication presented when they were happy, sad or in pain. The registered manager told us they were addressing this shortfall to ensure information available to staff was current.

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.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

People were supported to make informed choices and encouraged to make decisions as much as they could for themselves. Staff checked with people before providing care and support to gain their consent. A relative told us how staff and the provider had advocated on behalf of their family member who was unable to make their views known by themselves. The relative told us this had had a significant positive impact on their relative as it ensured they received the increased level of care they required.

Staff understood which decisions people could make for themselves and when they needed support to act in their best interests. They described people’s routines and daily lives and how people were enabled to choices such as what to wear and how to spend their time. Staff had accessed advocates when people lacked capacity and had no one to represent their interests. An advocate is an independent person who is trained to support people understand their rights, express their views and wishes and ensure their voice is heard.

Mental Capacity Assessments were not consistently undertaken according to best practice. In the majority of mental capacity assessments staff had engaged people in conversations to assess if they could understand, retain and weight up information in order to communicate their decision about the matter concerned. However, in some assessments the decision had been made that a person lacked capacity to make a decision without following these principles set out in the Mental Capacity Act 2015 (MCA). There were systems to monitor deprivations of liberty (DoLS) to ensure people were only deprived of their liberty to receive care and treatment when it was in their best interests and legally authorised under the MCA. However, these monitoring processes did not include ensuring that any DoLs conditions were consistently met. The provider addressed this shortfall during the assessment.