Competent Healthcare 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

During this assessment we looked at 1 quality statement in the key question of effective. The overall rating for this key question combines scoring from quality statements we looked at during this assessment and quality statements scores in line with findings from our last inspection, where the service was rated good. The provider did not always obtain valid consent to people’s care. Their processes were not always in line with The Mental Capacity Act 2005. This was a breach of Regulation 11 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

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 gave positive feedback about staff asking for consent before they provided any care. Comments included, “[Staff are] very respectful, they always ask whether I want help [with personal care]."

Staff had a good understanding of the need to gain consent to care. Staff understood that consent was required for individual tasks and needed to be obtained each time care was delivered.

Where people had lasting power of attorney (POA), the provider did not fully verify the scope of these granted powers. For example, one person’s care plan did not document whether the POA was for health, finance or both. The provider took a photocopy of the POA document, but only the front cover of the document. The information this photograph presented, did not document the name of the person who had POA or the breadth of their granted powers. Therefore, it was not clear whether the POA stated in the person’s care plan had authority to act on their behalf. There was no evidence of best interest meetings where people’s records reflected they may have a cognitive impairment and were unable to make decisions about their care. For example, one person’s medicines risk assessment detailed that their medicines should be locked away on account of having a cognitive impairment. There was no documented evidence of a capacity assessment, how this decision was made, who was involved and how this decision was agreed as being in the person’s best interests. The provider had not always established people’s wishes around Do not attempt cardiopulmonary resuscitation (DNACPR) decisions. Some care plans did not confirm whether these instructions were in place, what people’s instructions were or where associated paperwork was stored (in order for emergency workers to access). This meant it was not always clear what people’s wishes were around treatment in the event of a medical emergency.