Martindale Road

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 breaches of Regulation in relation to person-centred care. People's needs were not always assessed and planned for in a person-centred way. Staff did not follow best practice guidance for supporting people with a learning disability or monitor outcomes to make sure people's needs were being met. People were supported to stay healthy and access healthcare services when needed. The provider assessed people's mental capacity and made decisions in their best interests.

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.

A relative told us they were not involved in providing information for the person's assessment or care plan. The provider told us they had invited relatives to be involved in this process. People's needs had been assessed but information was not always clear or up to date. Furthermore, staff did not always understand how to meet these assessed needs. This meant people were at risk of receiving care which was inappropriate.

The staff told us they did not know how to meet everyone's assessed needs because they had not had the right support or training.

The provider had developed care plans based on people's assessed needs. However, these had not always been reviewed. This meant some information was not up to date. For example, one person's needs had changed following an illness. This was not reflected in their care plans. The care staff had not been involved in reviewing people's needs or updating care plans.

People did not always experience good quality care in accordance with best practice for people with a learning disability. Staff did not follow best practice to enable meaningful communication and understanding. People did not have active or varied lives and were not supported to achieve personal aspirations.

Staff were not able to describe about how they implemented evidence-based care in line with best practice guidance.

The provider's systems did not ensure staff had up to date knowledge of national legislation, evidence based good practice or required standards. The provider told us staff were encouraged to learn about new and innovative approaches. However, we found they did not always apply this learning. Care and support did not enable people to live as unique individuals. People's nutritional and hydration needs were met in line with current guidance.

Staff were not always aware of and did not always follow guidance from external professionals to ensure people's needs were being met. For example, some people had input from physiotherapists. Staff did not always continue to support people with the exercises in line with best practice.

The staff did not always know when or if external professionals had assessed people. For example, a member of staff said, ''There has not been any professional involved that I am aware of to support [person] with their mental health, I thought they might help [them] but nothing has come of it.'' They explained they did not understand how to follow best practice for a person who injured themselves. They also told us that following any assessments, the management team had not shared guidance with them or outcomes from these. The staff told us they had undertaken some training from external professionals to help understand how to care for people well. Although they explained they needed more guidance and support to implement their learning effectively.

An external professional told us they had discussed best practice and ways of working with the staff but they had not always followed their guidance. They also explained they did not always give them the information they needed. They explained they had provided training on 'sensory stories' (ways of using different senses to aid communication). However, they went on to tell us their guidance had not always been followed.

Care plans did not always contain the most up to date or clear guidance about how to implement recommendations from healthcare professionals. Following concerns about people being supported to eat and drink, the provider had updated guidelines around this, made sure all staff were familiar with these and organised for additional training.

People were supported to stay healthy. The staff had been proactive in recognising changes in people's health and wellbeing. They had sought medical attention for people when needed.

The staff were able to tell us about people's health conditions and how these were managed.

People had regular appointments with doctors and other health professionals when needed. The staff monitored their health.

People did not always receive care and support that was coordinated. They were not supported to work towards goals or aspirations. People did not consistently experience positive outcomes.

Staff did not always understand how to monitor outcomes or use this information to plan for people's care. Whilst the staff completed some monitoring charts, they did not use these to assess people's needs or develop new plans. Staff told us they understood how to complete monitoring charts, but they said they did not know what these were used for.

The processes for monitoring the effectiveness of care and how outcomes were achieved were not followed. Reviews of care were not holistic or meaningful. People's representatives and other professionals had not always been involved in reviewing or developing care plans. The provider told us they had invited these representatives to contribute.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). People's experience was consistent with the provider following the MCA. However, a relative told us they did not always feel involved in decisions or that they had enough information about these.

The staff told us they had received training regarding the MCA.

The provider had carried out assessments of people's mental capacity and applied for DoLS authorisations as needed. Information in some people's care plans needed to be updated to reflect current DoLS authorisations and any conditions relating to these.