The Oaklea Trust (Durham & Northumberland)

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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

The provider had not always considered or documented people’s capacity to consent in line with the Mental Capacity Act 2005. Where people lacked capacity to make their own decisions there was not always documentation to show decisions had been made in-line with MCA requirements and in their best interest. Staff had received training around the Mental Capacity Act 2005 and associated Code of Practice. Staff told us they felt they supported people to make informed decisions when care was delivered. People and relatives confirmed people were consulted in decision making, advocates and professionals were also involved for bigger decisions.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care needs were assessed, and they were involved in planning their care. Relatives or advocates were also involved in care planning and reviews of care.

Staff told us there were effective systems in place to assess and monitor people's needs. Staff told us there was an ongoing process of assessment and support planning with the person’s wishes and interests central to this.

Assessments included specialist advice and guidance from partners.

Systems were in place to ensure people’s care and support needs were met. People had initial needs assessments written involving people and their relatives. Assessments and support plans covered a range of physical and emotional needs such as mobility, nutrition, communication, and emotional wellbeing.

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.

People told us staff asked them about support before assisting them and we observed this in practice. We saw people lived full lives and did things of their choosing. However, people were not consistently supported to made decisions in-line with the Mental Capacity Act and code of practice.

Staff told us they supported people with decision making. One staff member told us, “Our customers all have very limited capacity to make decisions. I do always explain to them in a way I feel they would best understand to try to help them in any choices they are making.” Staff had received training around the Mental Capacity Act 2005 and associated Code of Practice. However, some staff did not know who lacked capacity or which decisions they needed support with. We saw limited evidence that staff had explored this with people and documented the outcomes. Staff told us some capacity information was recorded in initial assessments, but we found that this was not carried through into care plans and risk assessments to give staff detailed guidance on how to support people. Staff told us they did not have any standard MCA documents to help them record decision making.

People’s mental capacity and ability to consent to aspects of their care had not always been documented. Initial assessment documents covered capacity needs but not in detail. Information about capacity was not routinely explored in people’s care plans and risk assessments. Therefore, we could not be assured that staff always had access to the correct information to support people in-line with MCA requirements. Where people lack capacity to make decisions these should be made in their best interests. In some cases, the provider relied on other agencies to make these assessments but had not kept a record of the processes followed or the outcomes.