St Anne's Community Services - York DCA

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

We identified a continued breach of person-centred care. Although some improvements had been made, people’s needs were still not fully assessed to include aims, aspirations and ensure people lived the most fulfilling lives possible, in line with the ‘Right support, right care, right culture’ guidance. People were supported to eat well, and people were encouraged to participate in physical activity. People were supported to attend healthcare appointments. Staff made decisions in people’s best interests where needed and understood their responsibilities under the Mental Capacity Act.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Although some improvements had been made, and people were experiencing more active lives, people’s needs were still not fully assessed to include aims, aspirations and to ensure people lived the most fulfilling lives possible. Meaningful goals were not always in place for people and there was not a clear robust commitment to supporting people to increase their independence. Where an activity that people enjoyed wasn’t possible, the service had not always thought about or explored alternatives.

Although staff knew people well, they did not know about people’s longer term aims and aspirations. Although some goals were documented for people, staff and leaders had not worked with people and their relatives to develop meaningful goals. Leaders told us about plans to meet people’s sensory needs, but work had not started to implement these ideas when we visited the service.

Professionals had worked closely with the service to provide support. Professionals spoke about slow progress in some areas including the assessment of needs in people’s support plans.

Some improvements had been made since the previous inspection, but people’s needs were still not fully holistically assessed and met. There was no clear structure for developing people’s independence and life skills. People did not have meaningful goals in place. Some plans were in place, but they had not yet been implemented. Relatives had been involved in discussing people’s needs but there was no evidence of people themselves being involved to ensure assessments were fully meaningful.

Although relatives told us improvements had been made, people did not always receive support fully in line with best practice guidance such as the ‘Right support, right care, right culture’ guidance. People’s goals, skills and aspirations were not meaningfully assessed, recorded and worked towards.

Staff and leaders spoke about improvements in the delivery of care but hadn’t always recognised where support fell short of best practice guidance.

Processes in place had not identified that care and support was not always provided in a way which was in line with the ‘Right support, right care, right culture’ guidance. Systems were in place to support people’s nutrition and hydration needs. Staff were trying to increase the variety of people’s diets.

People were supported to access other services and healthcare professionals.

Staff and leaders were knowledgeable about how best to support people to access services in a way that worked for them and in a way that reduced distress and anxiety.

Professionals who had been working closely with the service confirmed progress had been slow, partly due to multiple changes in management.

There were systems in place to ensure the staff team communicated and worked together well. Hospital passports were in place to support people to smoothly access other services. Appropriate referrals to other services had been made, and advice was incorporated into people’s support plans.

People were supported to eat well, and people were encouraged to participate in physical activity. Opportunities to gain independence and life skills were not always maximised. Where activities people enjoyed were not possible, alternatives were not always explored.

Staff spoke about encouraging people to eat a wider variety of foods and slowly introducing different things. Staff also spoke about encouraging physical activity. Staff spoke about difficulties in promoting independence and life skills. Leaders had not provided robust guidance and actions for staff around this.

No concerns were received from partners about the service accessing healthcare professionals or implementing advice.

Processes were in place to make appropriate referrals to other services, and advice was incorporated into support plans. Some improvements had been made in respect of social activities to promote mental and emotional wellbeing, but further work was needed to proactively promote healthier and emotionally fulfilling lives.

People’s experiences at the service had improved. People were going out more and participating in more activities that they enjoyed. However, further improvement was required in this area to ensure people led fulfilling lives.

Staff and leaders spoke positively about the improvements at the service since the last inspection.

Process and systems were in place to monitor outcomes for people, however, these had not always identified where improvements could be made. People’s food and fluid intake was monitored to support people to have a balanced diet. Where people communicated through behaviours which may challenge others, these were recorded using ABC charts, and accidents and incidents were analysed for trends. Activities were recorded in daily notes. Audits confirmed that people were participating in more activities. However, audits and analyses had not identified where further actions were needed to ensure people lived as fulfilling a life as possible. It has not been identified that there were no meaningful goals in place for people, and no aims and aspirations. There was no robust commitment to improving people’s independence and life skills and this had not been identified through ongoing monitoring.

People and relatives did not raise any concerns around consent. There was no evidence that people were subject to inappropriate restraint or restrictions.

Staff made decisions in people’s best interests where needed, and these decisions were recorded. Staff understood their responsibilities under the Mental Capacity Act and confirmed they had received appropriate training.

The provider did not have copies of up to date Court of Protection Orders. However, the management team had taken steps to request this documentation.