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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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Care plans evidenced people’s physical, health, wellbeing and communication needs. People and relatives were actively involved in their care plans and regular reviews were taking place. People’s past histories were considered in care planning and staff knew people and their needs well.

People’s health needs and clinical observations were not always completed in line with current guidelines.

Whilst we found no harm to people, we found conflicting information on fluid and food intake forms for 1 person, regarding how much this person had consumed. There was no guidance for staff as to the minimum/maximum oral intake for this person, to enable staff to know when action needed to be taken.

People received monthly monitoring of their weight, to ensure peoples nutritional risk was monitored. However, weights had not been completed for people unable to weight bear. We discussed this with the management team on the day of our inspection and they assured us action would be taken to complete this in the future. Further staff training was required in relation to monitoring people’s nutritional risks, to enable staff to safely monitor people at risk of malnutrition and weight loss.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had access to health care professionals when required. The service involved people in regularly reviewing their health and wellbeing needs. Staff knew the needs of people well, one professional told us, “They [staff] are knowledgeable about residents needs and keep up to date with any changes.”

Staff demonstrated the ability to provide support, whilst empowering people to maintain their independence as much as possible. One person told us, “I used to like going by myself round the garden but since my sight got worse, I can’t do as much. So now, I have a treadmill in my room.”

The service had a good variety of physical activities, and we observed people being actively engaged and were seen to enjoy these.

People also told us that they enjoyed the quality of food on offer. One person said, “It’s very good, it varies each day and is tasty.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

People had support to improve and maintain their quality of life. Staff supported people to access social opportunities and build new skills. Any changes in people’s needs were notified to health professionals where appropriate, with guidance sought from professionals when needed.

One Professional told us that they have a good relationship with the service stating, “I visit at least weekly, and communication and rapport is outstanding.” Staff shared information between professionals to ensure people had a continuity of care. People were kept up to date with on-going health or care arrangements. Staff also had good knowledge on any changes to people’s individual care needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

People had support to improve and maintain their quality of life. Staff supported people to access social opportunities and build new skills. Any changes in people’s needs were notified to health professionals where appropriate, with guidance sought from professionals when needed.

One Professional told us that they have a good relationship with the service stating, “I visit at least weekly, and communication and rapport is outstanding.” Staff shared information between professionals to ensure people had a continuity of care. People were kept up to date with on-going health or care arrangements. Staff also had good knowledge on any changes to people’s individual care needs.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Whilst we observed staff offering choices to people throughout the day and gaining their consent, we found people’s care and support plans didn’t always consider a persons’ ability to consent to the care and treatment that they received. Assessments were not always carried out in line with the Mental Capacity Act, and there was a lack of information in care records, to evidence people’s capacity had been considered when requesting them to sign consent forms around their care and treatment. Staff on the day of inspection were receiving Mental Capacity Act training.