Collingswood 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

The key question of effective was rated for the first time at this assessment and was rated requires improvement. Peoples’ assessments and care plans were generally clear, comprehensive and provided guidance to staff to keep people safe. Each person had a copy of their care plan in their home and they and their relatives were involved in its development and review. However, assessment under the Mental Capacity Act 2005 (MCA) was missing from both peoples’ assessments and care plans. During our assessment in January 2024, we identified the management of the service was lacking knowledge and skills in applying the MCA in community settings. The service management had failed to gain either skills or knowledge about the application of the MCA since then, and so multiple situations where the MCA should have been applied had been missed. Due to this the service was in breach of regulation relating to consent. The service had failed to take its part in maintaining people’s human rights. Staff were being trained to carry out their care role. People were supported by staff to do as much as possible for themselves, to enable them to improve or maintain their abilities. Staff worked with people to support their general health and wellbeing. Although divided into area teams, staff worked well together to travel out of their own area to ensure people’s needs were always met. All care staff and office-based staff worked closely together to ensure all visits were carried out.

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.

People had a comprehensive assessment and care plan in place but questions regarding restrictions imposed on people who did not have capacity to consent, were not part of the assessment / care plan format.

Staff said they were able to understand how to meet people’s assessed care needs by reviewing their care plans. They said the care plans were available to them through the service’s IT App but sometimes at short notice there was not time to read the care plan between visits. Staff commented on needing to review care plans in their own time and in their own homes. All staff said they always aimed to care for people the best way they could.

The assessment process was thorough except around people’s capacity and restrictions of their freedom. Care coordinator staff worked hard to ensure initial assessments were carried out quickly when the service began to offer a person a service for the first time. Reviews of assessments and care plans were generally being carried out in a timely fashion. However, one person we spoke with correctly commented to us their assessment and care plan had not been updated despite significant changes occurring to their needs and abilities.

People and their relatives were involved in their care planning reviews and were kept aware of any changes to the care being provided to them.

Staff told us they were being adequately trained to carry out their care role. They said the arrival of a new training manager had improved the quality of the training they were receiving.

The service’s IT system was designed to meet current best practice standards and so could support staff and management in the design and delivery of peoples’ care.

People told us their care staff worked together to ensure they always received a service. However, people often said to us how important having the same group of staff was to them, so they got to know one another.

Both care staff and office-based managers told us the care teams worked well together. Staff travelled out of their own area to meet people’s needs, when the area team could not fully resource all their own visits. The managers of the service told us they had a good working relationship with both health and social care partners.

Neither health or social care professionals raised concerns to us about how the service worked with them.

Plymouth city was divided into individual staff team areas by the service, with staff in each team who designed the visit rosters, and care coordinators to oversee care. All care staff and office-based staff worked closely together to ensure all visits were carried out, even at short notice The service was part of a Plymouth wide scheme that coordinated between homecare agencies to ensure people’s need for community support was always met even when one service was in difficulties. The service said that this scheme was working well.

People were supported by staff to do as much as possible for themselves to enable them to improve or maintain their abilities. People said they were given choice in their support, and staff worked to support them to make healthy choices towards improving their general health and wellbeing.

Staff understood people’s needs and preferences both from their care plan, but also from meeting with a person new to them, before they began delivering care to them on their own. Staff told us these shadowing visits were very helpful to their knowledge of the person’s individual likes and dislikes.

Staff were supported to deliver food to people as they wanted, while encouraging people to have a balanced and nutritious diet.

People said their care was looked after and the service recognised changes and made amendments to their care planning as necessary. One person’s relative said, “The care plan is up to date – we re-did it two or three months ago."

Staff and managers told us about taking action to respond to information about care, coming in from the visiting staff. As necessary care coordinators made contact with people to discuss their care in response to this information.

The care monitoring systems used by the service were generally good. However, their system had failed to recognise when people without capacity might need to have their living situation as a whole risk assessed, to see if it was safe for them to live in a restricted environment.

People told us they were offered choice when their personal care was being delivered and their consent to personal care tasks was always asked for by staff.

Staff and managers told us about how people were asked for their consent in all elements of service delivery. However, neither the service management, care coordinators or staff had adequate awareness of the Mental Capacity Act 2005 (MCA) or how to apply it to the living situations of some of the people that used the service.

At our assessment in January 2024, we identified the management of the service was lacking knowledge and skills in applying the MCA in community settings and this was fed back to the service. The service managers and care coordinators had received training since our last assessment on how to carry out an assessment of a person’s ability to consent. But the service had failed to gain either skills or knowledge about the application of the MCA. The service also had no policies or procedures about the MCA or how to implement it in community settings. These failures around the use of the MCA were a breach of regulation.