Stradbroke Court

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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 inspected 2 quality statement for this key question, Monitoring and improving outcomes. We found that improvements were needed in care planning. The manager had identified this prior to our inspection and told us how they planned to improve the system.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.

Relatives told us they had been involved in the original care plan, but some were unable to recall being involved with a review. Relatives were satisfied the service monitored people’s well-being particularly in relation to eating and drinking.

The manager had identified where improvements were needed in the care review process and records, they told us they had recently introduced a resident of the day process. This meant all aspects of care for the person who was resident of the day would be reviewed once a month with the involvement of the person. The review included their care plan and accommodation. Contact would also made with relatives if appropriate. This new procedure would facilitate timely updating of care plans and people and their relative's involvement in the care planning process. One person had been reviewed under this procedure at the time of our inspection visit.

Management oversight of people’s care and support had improved since our previous inspection, but further improvements were still needed. Care plans contained information in several places and was not always reflected throughout the care plan. The language used in people’s care records did not always value people and we shared with the manager examples of where it could be more person centred and enabling. The subjective use of ‘suffers with’ was used to describe people’s conditions and people’s mental health risks were only discussed in terms of the ‘challenging behaviour’ care plan with outcomes not fully explored. The provider had appointed a compliance manager to support the manager with oversight. The nominated individual also told us planned improvements included introducing an electronic care planning system to improve and address inconsistencies with care planning and documentation.

People’s relatives told us that they believed consent was sought before care or support was provided. One person gave us an example of when their relative had refused consent for a particular procedure. Relatives confirmed that where they held a Power of Attorney the service held a copy of this.

Staff were aware of the need to obtain consent before providing any care and support and what to do if this was refused. A member of care staff told us, “I always ask for consent before providing care, and if a person refuses, I respect their choice and report it to senior staff.”

We observed mixed practice by staff when obtaining consent during our inspection visit. We observed a member of care staff supporting a person to eat and drink at their own pace. However, we also observed another member of staff pushing food into a person’s mouth and speaking over them. Records showed people provided consent in relation to their care and treatment where they had the capacity to do so. Where people living at the service were unable to make their own decisions and there was no power of attorney in place, records of best interest meetings and specific decisions were in place. Mental capacity assessments were decision specific and reviewed regularly. Staff had received training in mental capacity and the Deprivation of Liberty Safeguards (DoLS). Records demonstrated DoLS had been followed and authorisations requested where needed.