Paul Murphy Centre

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment, the rating has now changed to requires improvement. This meant people’s outcomes were not consistently good and assessments were not always reflective of people’s support needs and preferences. The provider was in breach of the legal regulation in relation to person-centred care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People’s needs were initially assessed at the first point of contact with the service, but needs were not routinely assessed on each period of respite. People’s representatives were involved at the initial assessment but were not always involved in ongoing care planning and planning for the future. Assessments were not always up to date and reflective of people’s current needs. One person’s dietary needs had changed following an admission to hospital, this had not been reflected in their care plan. Staff spoken with, were aware of the person’s new dietary requirements. Assessments did not always capture people’s skills, strengths and goals. Assessments did not always identify the support people needed to promote their independence. Assessments recorded accessible communication methods to support each person, but these methods were not always encouraged by the provider.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. The provider was not always working in line with evidence-based care and treatment. Where people had been identified with swallowing difficulties, care records lacked sufficient information in relation to International Dysphagia Diet Standardisation Initiative (IDDSI Framework). One person was described in their care plan as requiring a soft and bite-sized diet; however, no further guidance had been recorded on the most suitable food for the person. Another person required their fluids thickened to prevent choking but there was no guidance recorded in the care plan as to the level of thickened fluid most suitable.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. Further improvements were needed to ensure people’s care was planned and delivered in line with their assessment and preferences. We saw an example where a person’s communication aid was not being charged at the home prior to them attending education and this had been raised by the educational provider. A communication book had been put in place for one person between the home and the person’s representatives, but the book was not always being completed. Care records lacked information relating to people’s goals, dreams and aspirations. The provider was not continually assessing and planning people’s care in relation to ongoing care arrangements and future plans.

The provider supported people to manage their health and wellbeing. People had health actions plans in place which assisted in identifying their individual needs and support required to maintain their health. Staff were able to describe how each person communicated they maybe in pain, for example, by pointing to the area or crying. People were reviewed by the GP promptly when they had a period of ill health. Staff told us, they can see changes in people’s health by their appearance and report any concerns to the team leader.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Care records were not always reviewed within agreed timescales to ensure they accurately reflected each person’s agreed outcomes. Some records had not been reviewed for several months. There was no evidence people were involved in reviewing their care records. Peoples’s representatives told us they had not been involved in ongoing care planning

The staff team did understand the importance of gaining consent, but further communication strategies had not been explored to ensure people were able to consent or refuse specific decisions or care interventions. Consent to care and support was obtained at the beginning of a placement but there was no ongoing review of consent to ensure people understood their care and treatment.