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 assessed a total of 6 quality statements from this key question. Risk assessments and care plans identified aspects of people’s care which required evidence-based care and treatment to be followed. People and their relatives participated in their care plans and agreed the support they required. We received mixed feedback about whether staff worked effectively. Some improvement was needed to people’s care plans as some lacked detail.

This service scored 67 (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. One family member told us, “I was involved with care plan when originally put in place.”

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

People’s needs were assessed, and care was agreed before they received a service. Appropriate records had been developed which reflected their identified care needs.

People told us they received care based upon their preference. People were supported to eat and drink when needed. However, one family member felt staff did not use the correct equipment to assist at mealtimes. We fed this back to the registered manager who told us they would contact the family member and review as 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. In some care plans, the detail was not always sufficiently detailed. For example, one person needed food to be modified due to a risk of choking. The family member prepared the meals however there was a lack of guidance for staff so they could ensure the food was modified to the correct consistency. This was raised with the registered manager who told us they would review this aspect of the person’s care with the relative. We checked the person’s records during the assessment and confirmed the care plan had been updated.

We received mixed feedback about whether staff worked effectively. One family member said some staff were good at keeping them updated however this was not consistent. Other family members felt very well informed. One commented, “Yes, I am kept informed, and any changes are reviewed, and I am involved.” Another told us, “The staff work well together.”

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

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

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 were communicated to staff via the electronic care planning system. However, care plans were not always promptly updated. For example, one person had been advised to use additional equipment to alleviate the risk of pressure sores. This had been communicated via message to all staff however the care plan did not reflect this instruction. This meant new staff would not have readily been aware of the change through the records available.

People were encouraged to manage their health needs where possible with support from staff. Family members confirmed people were supported to access other services when needed. One relative told us, “The staff understand my relatives health issues well.”

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

Care plans identified the different services people accessed to support them to live healthier lives. Where appropriate, information was shared with staff and records were maintained following appointments or feedback from professionals who worked with people.

People told us they felt people’s outcomes were identified and monitored. One family member told us, “I am involved in reviews, and we can also keep track through the online system. The reports are detailed.”

Staff described the process for monitoring and improving outcomes for people. This included an allocated keyworker who worked with the service user and family to identify future outcomes and goals.

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

People confirmed staff sought consent from people and respected people’s decisions. One family member told us, “Yes, they are respectful, and they will ask if mum won’t do something.” Another family member told us, “They will ask for permission to do something. If mum refuses, they will provide alternatives.”

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

Records to demonstrate the services was aware of people’s capacity to consent to care was not always robust, nor consistent. One person had conflicting information whether they could consent to or make decisions about their care. There were no records maintained of other legal arrangements in place for other others to make decisions on a person’s behalf. We raised this and the registered manager took immediate actions to address these shortfalls. Records for other people were clearer whether a person had capacity to consent to the care they received.