Quinton House

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

People’s needs and rights were not always supported effectively. Staff were aware of people’s preferences but did not always manage these in a person-centred way. Staff did not always have good knowledge of the mental capacity act, including capacity and consent. The registered manager told us they had sought support from the local authority to strengthen their knowledge in this area. Records showed work had started on improving mental capacity assessments. People told us they were aware of their rights around care and treatment and felt staff respected them.

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 told us that they were involved with planning their care. One person said, “I’ve been here over 20 years. When I first came here, I got the care I needed and wanted. They helped me get lots of tests to help me be healthy and to also to lose weight. I feel great about myself.” The person also told us, “They talk to me about it (care plan), but I don’t read my care plan much, but I know I’ve got one.” Relatives we spoke with told us staff also understood their relatives needs and how best to support them. One relative said, “They are doing their upmost to meet his needs, they know him very well, I have no concerns. Any appointments they make for him.”

Staff had access to documents on how to support people, however some of the assessments lacked detail to ensure staff had the correct information in how to support people safely. For example, a risk assessment relating to emotional support detailed very little information about the person. Care records were reviewed monthly. National assessment tools were used, to understand people’s needs and how best to support them. For example, Waterlow and MUST risk assessments were completed for all people. Best practice guidance was followed in regards to ensuring all people with a learning disability were supported to have at least a yearly review with their named doctor. Records we reviewed showed people were supported to attend these appointments. People were supported their oral health, all people living at the home visited the dentist at least every six months.

The registered manager knew people’s health needs well, they ensured where people needed to see an external healthcare professional this was done. They gave us examples of when people have needed to see the GP, Optician, and audiologist. They discussed an example of a person who had been referred to the continence team, however this was not chased up in a timely manner.

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 told us they were involved with decisions about their care, and they were not forced to do anything they didn’t want to. A person with some communication difficulties was seen throughout the day to be asking staff for permission to carry out certain tasks such as requesting food or going to their bedroom. Whilst observations are not an evidence category within this quality statement, it was observed there was a structure to people’s days, which was decided by staff.

Staff received training in the Mental Capacity Act, but demonstrated poor knowledge of restrictive practice. We were therefore not assured that this training was effective. However, staff spoke with passion about wanting people to live fulfilled lives. Staff we spoke with said, “I want people to be happy and the best part of my job is that I am making a difference to people.” The registered manager explained they had only recently completed some mental capacity assessments (MCA's) and best interest (BI) documentation for people living at the service. No DoLs applications had been made for anyone living at the service despite restrictions being imposed on people. They demonstrated limited knowledge and further training was required to ensure people lived free from unlawful restrictions. The registered manager did ensure where they felt a person’s voice was not being heard they had acted on behalf of them. For example, the registered manager gave an example of a relative not acting on behalf of a persons wishes, they discussed the issues with the relative and acted as an advocate on behalf of the person.

The provider was not always working within the principles of the MCA. Mental capacity assessments had not always been completed in line with legal requirements, guidance, and best practice. When people had been assessed as lacking capacity or had fluctuating capacity to make decisions about their care, MCA's and best interest decisions were inconsistently completed. For example, an MCA completed for one person in regards to medicines was not completed in line with best practice guidance, the information gathered detailed the person had some understanding of managing their medicines, but staff had assessed them as lacking capacity in this area. The questions asked were not in a simple format there was no detail to demonstrate if any materials or simple language was used to aid understanding. This demonstrated staff did not have a thorough understanding of the MCA. Care plans did not always clearly document people's capacity to consent and to make decisions. For example, a person's care records documented MCAs had been completed in decision specific areas, such as accessing the community these were not always completed. For example, the MCA used terminology such as the ‘green cross code’ however it was not clear if the person had been explained what this was and there was no documentation to evidence this terminology had been explained in simpler terms. The registered manager had begun completing MCA’s and BI for all people living at the home where required. They recognised the process required improving and had begun reviewing these prior to our inspection. We found some MCA’s had been completed in line with guidance. For example, an MCA relating to money was detailed and demonstrated appropriate communication had been used to determine the persons capacity. A best interest decision meeting was in process for one person in regards to a health condition, their representative had been contacted and was attending the meeting in line with best practice guidelines.