Sister Winifred Laver Promoting Independence Centre

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. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. The service was in breach of legal regulation in relation to seeking consent to people’s care.

This service scored 46 (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 was effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People’s needs had not been comprehensively assessed when they were admitted to the service. The admission checklist contained questions about people’s needs. However, this lacked enough details to make an accurate assessment of the support people required. There was also very little information documented to show people were meaningfully involved in deciding what support they required. Support and therapy staff told us referral information was brief, resulting in unsuitable admissions to the service.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’ care was not always delivered in line with best practice. For example, elements of medicines administration were not in line with National Institute for Health and Care Excellence (NICE) guidance and good practice. People gave some positive feedback about the meals provided at the service. Where required, people were referred to a speech and language therapist (SALT) for advice and guidance. However, during observations staff did not consistently follow the recommendations given for one person. We raised this with management at the time to be investigated.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. People’s care plans contained very little information about the recommendations the therapy teams, based on-site, had given. Support and therapy staff consistently told us teamwork and communication needed to improve to ensure people received holistic care. The provider had received similar feedback in their most recent staff survey, where 55% of the staff who had responded, rated communication as poor. The provider told us they had taken action to improve this, although this was not always evident.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Care plans lacked information about the support people needed to meet their health-related needs. Some people had specific health conditions, however, they did not always have a care plan to ensure they received the support they needed from staff. Support and therapy staff consistently told us a high number of admissions were unsuitable for the intended purpose of the service, with many people having longer term nursing or complex needs.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. The provider was unable to provide us with evidence people’s care was effectively monitored. People’s care plans lacked clear goals and outcomes to enable progress to be measured. Care plan evaluations were not always completed in line with the provider’s expectations.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. The provider was not following the Mental Capacity Act (MCA) consistently to ensure people consented to the care they received. Some people had restrictions placed on them, such as bed and chair sensors. The provider was unable to evidence MCA assessments and best interest decisions had been carried out for people unable to consent to these. Where people had capacity, the provider was also unable to provide evidence of signed consent. The registered manager told us this was not done. Care plans and other care records were not consistently signed and/or dated to confirm people had agreed to the information recorded.