Sambhana Care Ltd

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 this key question was not assessed. At this assessment the rating is inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes. The service was in breach of a legal regulation in relation to seeking people’s consent.

This service scored 29 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. There had been no improvement since our last assessment. The manager had spoken to a couple of relatives to discuss the person’s needs, but there were no records to confirm this had continued. Most care plans had not been developed involving people or their representatives. People’s care plans and risk assessments did not include nationally recognised tools such as Waterlow to assess skin integrity or put guidance in place to reduce the risk.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards. There was no evidence people had been involved in planning their care and support. People’s capacity to make decisions had not been considered when changes were made to their care and support. When people’s needs had changed, staff had not reviewed their care plans to make sure the guidance was relevant and accurate. For example, when people returned from hospital care plans had not been reviewed or updated, to include changes to their needs such as a catheter. Care plans did not contain guidance following best practice such as catheter care and modified diets.

The provider did not work well across teams and services to support people. They did not share their assessment of people’s needs when moving between different services. The information available to send with people when they attended appointments or went into hospital was not accurate. The care plans did not contain essential information, for example, when additional support was provided by staff not employed by the provider. People who were receiving support from other care agencies alongside Sambhana Care Limited did not have handover documents or care notes for this support. This placed people at risk as both sets of staff did not have access to information about the support the other staff had given.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Staff did not always recognise when they needed to call for medical help or refer people to healthcare professionals. For example, staff undertook an assessment of a person following an incident and decided not to seek medical attention to check they were well. People and relatives told us staff supported them to make appointments to access vaccinations and the GP when they requested support.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. The provider did not have a process to monitor the outcomes of the support provided by staff. People’s needs were not reviewed regularly to assess if the support being provided was appropriate and meeting people’s current needs. For example, when people’s skin integrity needs changed this had not been reviewed and guidance changed. There was no process to meet with people to identify where changes could be made to make improvements to people’s quality of life.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. The provider and staff did not follow the Mental Capacity Act 2005 (MCA) in relation to people’s capacity and consent, people’s rights had not been upheld and people had not been supported to make decisions. One person lived by themselves and did not have relatives in this country, they had previously had many visits from people in their local community. The provider told us they had decided there were too many people accessing the person’s home and it was decided to stop visitors. It was decided the person would go to their religious meeting place with staff once a week instead. Staff had not undertaken a capacity assessment to check if the person had capacity to make the decision or not. It was decided this was in the person’s best interests to stop their friends coming to their house and it was what the person would have wanted. However, this left the person with no human contact apart from 4 half hour calls a day, placing them at risk of isolation, depression and accidents. There was no indication the person had initiated the intervention or had been unhappy with the previous arrangement.