Clifton Gardens Resource Centre

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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

Assessments did not always reflect people's needs or preferences. Information about how to meet people's needs was not always clearly recorded. This included information about healthcare needs. Most people felt they had the support they needed when they become unwell. However, a visitor told us about a situation when a person became unwell, and they felt there had not been enough timely intervention to prevent this. We identified breaches in relation to person-centred care. We did not assess all the quality statements within this key question. We did not identify concerns relating to these areas which we judged as being met at our last inspection.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People's needs had not always been assessed or planned for. Information within care plans and assessments was not consistently recorded. Some records were not dated or did not have the correct information about the person. For example, the care assessments for 1 person stated they were diabetic in some records, had 'undiagnosed dementia' in other records and neither of these conditions in further records. There were no plans to manage either of these conditions. The assessments relating to people's nutritional needs were basic and did not include reference to conditions which may impact on these needs. There was not enough information about people's needs and how these should be met. Plans were often generic and not personalised about the individual and how they needed or wanted to be cared for. Failure to assess people's needs in a way which was appropriate, met their needs and reflected their preferences was a breach of Regulation 9 (person-centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations.

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.

One relative described a situation when a person had become dehydrated and hospitalised. They told us they did not feel the staff had done enough to keep the person safe, hydrated and well. People told us they regularly saw a doctor if needed. Although, they and their relatives explained they needed to make their own arrangements to see a dentist. Their comments included, ''The doctor visits and I can see them if I need to'' and ''The staff take care of us if we don’t feel well.'' Some relatives felt there needed to be improved communication around health needs. One relative explained the staff had told them the doctor had given advice which the relatives could not understand. They told us they needed more explanation around this. Another relative said they would like to speak with a specialist but did not know how to do this. The registered manager told us they had facilitated some meetings between families and healthcare professionals. They also told us they made timely referrals to external professionals when they identified a change in a person's health.

Staff had not always had the training they needed to provide best practice and effective care for people with different health conditions. For example, the training record indicated most staff had not had dementia training, training to understand mental health needs, learning disabilities or autism, or training in how to provide oral healthcare support. This meant the staff may not be providing effective care in line with best practice and therefore, people were not receiving person centred care. The management team explained there were regular visits from a GP and community nurses. Records confirmed this.

There were no risk assessments or care plans in place regarding some people's health conditions. For example, some people were recorded as having diabetes. This condition impacts on people's general health, diet and other areas of their care, such as skin integrity. We viewed the care plans for 2 people who had diabetes and found care plans did not contain enough information about how to keep them safe or meet their needs. Some care records listed extensive lists of different health conditions for people. However, the guidance for staff only stated, ''Ensure my health is monitored and any concerns reported to the duty officer.'' This did not provide enough information for staff to recognise signs and symptoms of ill health or deterioration associated with the person's conditions. The staff recorded when people had been seen by a visiting health professional, or when they had appointments. However, these records did not always record what had been discussed or the outcome. This meant there was not enough information to help make sure staff were providing effective personalised care. Failure to plan, assess and meet people's needs was a breach of Regulation 9 (person-centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.