Pharos Supported Services

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

Systems in place to assess people’s needs were not always effective. People were not consistently at the centre of their care, and care plans to guide and inform staff did not always have the information needed to ensure people received the best outcomes.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us staff asked them about their care. One person had been supported to develop their own introduction to their needs and preferences for staff that would be working alongside them. Most relatives stated they had seen people’s care plans and said they felt involved in their family member's care planning and decision making. A relative told us, “Yes, they [staff] do everything discussed with me.” Another relative told us they attended a care review every year. However, a few relatives told us they were not always kept up to date with information about their family member’s care.

Most staff we spoke with had a good understanding of the needs of the people they were supporting. Staff told us they were provided with information before a new person moved into the supporting living service. Some staff told us the supported living environment a person was living in did not meet their needs.

We received positive feedback from stakeholders about how the provider had worked with them when people were transitioning into one of the services. They told us there had been good communication, detailed planning and good partnership working.

The provider had processes in place designed to enable them to assess and meet people’s individual needs, but these were not always robustly followed. Reviews of care plans and risk assessments were not robust and did not ensure the information and guidance for staff on meeting people’s needs was up-to-date or effective. One person’s care plan contained conflicting information for staff to follow regarding their bowel care. Another person’s care plan regarding monitoring food and fluid intake was not being consistently followed by staff and the required monitoring records were not maintained, which increased the risk of harm to the person. There were no protocols or risk assessments in place for another person where relatives were involved with their care and a risk assessment for a specific health need was not in place for this person. The provider had an admissions policy. Following discussions with them during the assessment, they told us this had been updated to include how they worked collaboratively with providers, when people transitioned to another service.

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 they were supported to make day to day decisions about their care. They told us about all the different things they enjoyed doing and how well staff supported them to do the things they enjoyed. A relative told us their family member was involved in decisions' about their care. They told us, “I think they do [participate in decision making] yes. They judge what they’re going to do on the day. They say to me they have gone out for a walk or picnic; depends how they are. They have a fantastic life.”

Staff and management we spoke with had some understanding of people's rights under the Mental Capacity Act 2005. We saw staff encouraged people to make everyday decisions. For example, what people wanted to do and how they spent their time, what to eat and drink. However, staff were unclear and, at times, confused about what safeguards were in place for people under close supervision.

People’s rights under the Mental Capacity Act 2005 were not fully supported or always understood by staff. This included a lack of clarity and robust recording in relation to any authorised deprivations of people’s liberty. Staff completed daily records when they had discussions with people about their care and decisions in relation to their care (key worker meetings). However, we saw there were often unexplained gaps in these records.