The Court

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 assessed 4 quality statements out of 6 within the effective key question. At the last Inspection we found this key question to be Inadequate. We found improvements had been made since the previous inspection on 14 June 2023. The service was no longer in breach of regulations relating to supporting people to eat and drink enough to maintain a balanced diet. This meant the effectiveness of people's care, treatment and support were much improved. Systems that were in place to ensure consent to care and treatment required improvement as there was no evidence of the Power of Attorney to ensure they had the legal authority to make decisions on the person’s behalf. Information regarding whether people had capacity to make specific decisions was inconsistent within different plans of care. When people had a Deprivation of Liberty Safeguards in place, there were no care plans created to ensure staff were aware of the deprivation and any agreed conditions for that person.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us they were involved in the assessment of people’s needs and the creation of people’s care plans and regular reviews and they were kept informed of any changes. They said that communication plans gave them enough information to know how best to communicate with people. One staff member described some basic signs staff use to support a person that had a hearing impairment.

All relevant care plans in place that are person centred, detailed and contain outcomes. They promote independence and are written in respectful language.

People told us they enjoyed the meals available to them; they always had a choice of meal and alternatives if they did not want what was on the menu. People had enough to eat and drink. A relative told us they were aware staff were monitoring their family members intake to ensure they ate and drank enough.

Staff told us they always had information regarding people’s dietary needs and preferences. They were aware if people were diabetic or had any intolerances that may impact on them and monitored people’s intake if they had any concerns. Staff said they had sufficient time to support people with their meals if needed and believed that the meals were of good quality and always a choice available. Staff told us they all work hard to meet standards.

People’s nutritional needs and preferences were assessed and recorded within their care plans. Procedures were in place to ensure staff had access to information regarding any specialist dietary needs, and preferences regarding food and drinks. Nutritional risk assessments were in place, although they were not always completed accurately. People had their weight monitored regularly and diet and fluid charts were completed to help ensure people ate and drank enough. It was evident that referrals had been made to other professionals for their professional advice when there were concerns regarding people’s intake, and this advice was incorporated within care plans. Menu’s were displayed and showed there was always a choice of meal available.

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.

Staff supported people in ways that improved outcomes for people. People told us staff knew them well and how to meet their needs. One relative described how their family member had improved greatly since moving into the home, they said, "When [family member] first came in he couldn't walk, couldn't feed himself, but the way the girls here have worked with him, it is amazing. He is comfortable and settled. He is mobile now." They described how staff supported the person with a new health condition and worked with family members to do this. Another relative told us communication had greatly improved and this meant things were followed up and not missed, such as appointments and tests.

Care plans contained clear outcomes people aimed to achieve. The plans were reviewed regularly and updated in the event of any changes. There was evidence that people and their relatives were involved in reviews of care and were asked for their feedback on a regular basis.

Staff told us they always asked for people’s consent before providing any care. If people refuse care they offer again later and ensure this is documented and reported to senior staff, or ask another member of staff to offer support.

Systems were in place to gain and record people’s consent but were not robust. When required, mental capacity assessments were completed to assess people’s capacity to make specific decisions. Best interest decisions were also recorded when people lacked the capacity to make a particular decision. We found however, that these processes were not always consistently followed and the principles of the Mental Capacity Act (MCA) were not always adhered to. For example, one person’s care plan stated they had capacity to decide to reside in the home, but also had a Deprivation of Liberty Safeguard (DoLs) application in place. Another person’s care file stated their family member had Power of Attorney and consent forms had been signed by them, but there was no evidence of the Power of Attorney to ensure they had the legal authority to make decisions on the person’s behalf. Information regarding whether people had capacity to make specific decisions was inconsistent within different plans of care. When people had a DoLs in place, there were no care plans created to ensure staff were aware of the deprivation and any agreed conditions for that person.