203 Hoylake Road

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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

We reviewed 6 quality statements under this key question; 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 and consent to care and treatment. People confirmed they were involved in the development of their care package before the care was delivered. Staff described how people were were involved in their care and support from the initial assessment and care planning to ongoing reviews and decision making. There were effective approaches to monitor people’s care and treatment and their outcomes.

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 confirmed they were involved in the development of their care package before the care was delivered.

Staff described how people were involved in their care and support from the initial assessment and care planning to ongoing reviews and decision making.

A recent review of quality had been undertaken by commissioners for the service. These had identified some improvements required in the quality of the service. An updated action plan demonstrated that while progress had been made, further work was needed in respect of mental capacity assessments.

Processes in place evidenced people's care needs were assessed and agreed before starting the service. Records of pre-admission assessments were observed. People’s records were accurate to the care they were receiving, work was ongoing to develop care plans further.

People told us they received care based upon their preference. People told us they were supported to eat and drink when needed.

Staff described how they worked with multi-disciplinary teams and other professionals to ensure professional guidance was followed and reflected within care plans.

Risk assessments and care plans identified aspects of people’s care which required evidence-based care and treatment to be followed. Systems to review care plans were in place, however had not always identified areas for improvement. For example care practice we observed to ensure the safety of one person had not been included within their care plan. The care plan of another person living at the same address had this information included in their care plan. It was not clear whether the same safety considerations were applicable to this person or whether information had been entered into the wrong care plan.

Family members told us they were happy with the consistency of staff and how they were informed of any changes. A relative told us, "Staff work well together". Feedback from a person reflected, "I like the staff but I don't get on with everyone".

Staff described the positive working relationships with professionals including GP’s and how effective communication was maintained to ensure people were supported.

A recent review of quality had been undertaken for the service by a local authority. This identified some shortfalls in demonstrating staff were supporting people to access regular reviews with GP or specialist medical teams.

Processes were in place to ensure the sharing of information for people's care needs were accurately recorded. Peoples care plans included details of other services and professionals who were involved in a person’s care and treatment. This included records of any known appointments, and advice given. Changes to people’s care needs were communicated to staff via the electronic care planning system.

Family members confirmed people were supported to access other health services such as doctors and other health professionals when needed. A person who used the service stated, "Yes I go to the Doctor if I'm not well but I don't always agree with what they say with my blood sugar checks".

Staff described the support provided for people to live healthier lives. Examples included supporting people with meal plans, shopping, and food preparation.

During a recent review undertaken for the service by a local authority, it was identified there were shortfalls in people accessing other services to improve their health outcomes. The provider had implemented improvements, however the effectiveness of these were not yet assessed.

Care plans identified the different services people accessed to support them to live healthier lives. Where appropriate, information was shared with staff and care plan records were updated following appointments or feedback from professionals. Records identified gaps with staff supporting people to access regular reviews with GP or specialist medical teams.

People told us they felt their outcomes were identified and monitored. One person told us that staff gave them the freedom to pursue community activities of their choice and preferences.

Staff described the process for monitoring and improving outcomes for people through ongoing reviews. This included an allocated key worker who worked with people and families to identify future outcomes and goals.

People’s care and support needs were routinely monitored by the management team through care file audits. Reviews were undertaken either over the telephone or face to face. People’s views about their care was obtained as well as any changes to care plans agreed.

People confirmed staff sought consent from them and respected their decisions.

Staff described the process for consent to care and treatment and gave examples as to how they supported people to make decisions.

Records to demonstrate the service was aware of people’s capacity to consent to care was not always robust, nor consistent. While people’s capacity to make decisions had been recognised in conjunction with the MCA (Mental Capacity Assessments) Code of Practice 2005, no best interest decisions had been reached relating to restrictive practices which had been identified.