Chepstow House

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• 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 assessed 6 quality statements in the effective key question and found areas of good practice. People’s needs and rights were supported. Care and support for people was effective. People had their health, care, well-being, and communication needs assessed. Care plans were reflective of people’s support needs and reviewed in a timely manner. Staff were aware of people’s preferences and respected these. Peoples’ capacity to make decisions was assessed and the information was part of their care plans. Staff had good knowledge of the Mental Capacity Act, including capacity and consent. Relatives had not always been involved in planning for peoples’ care needs.

This service scored 71 (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 their family member’s appointee but said, “I have not seen [family member’s] care plan.” The regional manager said relatives would be included in planning for their relatives care (subject to the person agreeing to this, if they have capacity to do this). One relative told us their family member’s needs were met as they were provided with what they needed. For example, they were provided with the appropriate equipment they needed for their mobility. Another relative said, “Staff are on the ball and keep [person] safe.”

Staff told us that managers put peoples’ care plans together though they carried out monthly reviews with people. If they thought plans needed updating, they left a note for the care plans to be changed, and they were changed regularly. People had involvement if they were able to. Information came from families and people. Staff said person centred care was provided and this was peoples’ own wishes, their preferences and choices, not the convenience of staff - what they wanted and were happy with.

There was a process in place to assess peoples’ needs including peoples’ health needs, early warning signs for medical conditions, their capacity to make their own choices, their strengths and the development of new skills. A person was recorded as needing a review of their needs in July 2024 but there was no evidence this had been carried out. Another person had not had a review of their nutritional needs.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

A person told us that staff talked to her and let her know what support they were going to provide during personal care. We saw a person’s care plan which had been reviewed recently which covered their health, wellbeing and care needs. Staff supported the person to make simple day to day decisions, or care was provided in the person’s best interests.

Staff understood the importance of gaining consent from people before they deliver care. One staff member told us, “During training we learnt how we must always ask and involve the person. For example, ask them what they would like to wear, what they would like to eat and drink. We encourage people to make their own choices.” Another staff member explained how they consulted others such as families, where appropriate, where a person lacked capacity to make decisions about their care and support.

Assessments were in place to properly assess peoples’ capacity to make decisions, and to consult people whenever possible.