Taylor Support Hub

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

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 requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. The service was in breach of legal regulations relating to consent and treatment.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us they were involved in developing people’s care plans. One relative told us, “They [staff] do an Individual Support Plan and that’s updated. It’s been updated not long ago; it gets updated about every year. Anything I raise it gets added to it and an email gets sent round to the team, so I know the info has been passed on.” Another relative said, “Yeah definitely [involved]. A lot of suggestions and situations that have occurred have come from team themselves and they raise issues. They [the provider] work quite well together.”

Staff knew people well and told us they felt they had enough information to support people effectively. One staff member said, “I think the care plans are good and give me the necessary information, I do feel they could be expanded though to allow more information.” Staff explained they supported people in line with their protected characteristics and consider equality and diversity in how they supported people. One staff member said, “We support people with diverse needs. Where we are doing an activity which is in conflict with their beliefs or cultural background, we will support them to do something different or make it more appropriate for them.”

People did have individualised assessments in place; however, as we explore throughout this report, these did not always incorporate all the information needed. There was missing information in relation to how people needed to be supported during times of distress and modified diets, for example.

Some relatives felt improvements were needed to support people to eat more healthily. A relative told us, “I’ve had an issue a few times, I don’t think it is the fact they aren’t paying attention; I think it’s the turnover of staff. I like my relative to eat as healthy as possible. If my relative asks for something, staff will give it to them. I’ve had to say it about 3 times. My relative can overeat. My relative doesn’t have sugary breakfast at home, so I don’t want it [when with staff].” Another relative said, “My relative is not independent with food. They need help with choices. My only criticism, we eat quite well, and I do feel when out and about [with staff] it’s not great choices. I worry my relative eats too much junk. They could cook when away, but not everyone is a healthy eater.”

Staff confirmed they were aware of people’s modified diets and had training to support people safely. One staff member said, “We support people with modified diets. We have training from speech and language about this. Staff will always get extra training if people need support with food and drink.”

One person’s risk assessment referred to them having a modified diet. The person’s relative had shared details of the person’s modified diet with the provider. However, other records related to their support needs, including the provider’s care plan and plans written by other health professionals did not refer to the same modified diet. The provider had not checked or clarified with the relevant professionals what the correct consistency was, so they could be sure they were supporting the person safely. In addition, information about how best to support the person when they were eating and in relation to equipment needed to keep the person safe was included in advice from a professional, but this had not been reflected in the person’s care plan. This meant there was a risk staff may not be aware of this advice.

Another person’s plan referred to them being able to have a diet which was not always in line with their needs, however the provider had not checked this was safe to do as it could have caused the person discomfort.

People were generally supported by their relative in relation to their health needs. Staff supported people periodically rather than daily, so were not expected to support people to access other health professionals, unless it was on an emergency basis. People had not required emergency support.

Staff had meetings to discuss people’s needs, and any changes needed in their care. Staff felt they had access to enough information to support people and felt supported by colleagues if needed. A staff member said, “The care plans are good, and someone is always available to assist if you need advice.”

Other professionals fed back the provider worked well with them. One professional said, “When I asked for recordings, they have been more than helpful. They have done what they can to meet that request.”

The provider worked in partnership with other professionals and organisations. However, guidance from other professionals had not always been incorporated into people’s care plans alongside the personalised information shared by relative, to give staff a complete guide for staff on how to safely support a person.

People were generally supported by relatives to access health appointments, rather than supported by staff. As mentioned, some relatives felt staff needed to be more mindful of food choices for people to reduce the risk of people eating regular unhealthy options.

Staff told us they supported people to be healthy. One staff member said, “We support people to be healthy and a lot of our activities support this. People asked to go swimming in a meeting. This was arranged quickly and there is now a swimming group. We also visit gyms and the company have set up a football team in conjunction with [local football team].”

As people’s care plans did not always have complete information or evidence of involvement from other professionals, we could not be sure staff always had access to correct information.

Relatives were positive about the feedback they received from staff, so relatives knew how the support had been for their loved one. One relative said, “Staff are very good, they tell us before the session what they are planning on doing, they feedback about how our has been, they are good. They feed back about my relatives bowel movements, as it is part of monitoring behaviours.” Another relative told us, “My relative is developing, and they [staff] are aware of that. They are quick to [help my relative maintain their dignity]. That’s important for me. My relative doesn’t understand, and staff are aware and supportive. I feel staff offer a really good handover. If my relative has displayed a behaviour, the staff tell us if something has happened.”

Staff told us there was not a formal handover process, as support to people was not always on a daily basis, there may be days or weeks between when they were supported by staff from Taylor Support Hub. However, staff were able to access information about the previous times people were supported and there was a messaging app used to share information and communicate between staff, if needed. However, the registered manager explained to us there were diaries in place staff completed after staff supporting a person overnight, which would go home with the person.

The provider had a process in place to document the monitoring and outcomes people achieved. Staff had to complete a report on the support they offered to people during the residential breaks. This was to enable information sharing and evidence the care people had received. The provider had a system in place to review these, track if any reports were missing to follow up with staff they were completed. We also saw an example where a report had been completed but did not contain much detail, so a member of the management team fed back to the staff member about this and requested more information.

Relatives did not raise any concerns with us about this. However, relatives noted some people would answer with a positive response, but this may not always be how the people felt, so staff would have to be skilled at recognising times people may not actually want to do something and they feel staff less familiar with people may not be aware of this.

Despite this, relatives also had positive feedback. One relative said, “They are good advocates for my relative. Staff don’t just say they’ve had a good day, they’ve said when my relative didn’t like something to make my relative’s life better.” Another relative said, “The staff always seem very kind to my relative, they can hear my relative’s opinions and likes and dislikes.”

Staff were person-centred and told us they offered choices to people.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. There was a chance people would not always be protected as the mechanisms to ensure people were empowered to make their own choices were not in place. The provider did not have decision-specific mental capacity assessments in place and had not followed the MCA. The provider had attempted to get advice to support them to put assessments in place, however this had not been effective, and people still did not have appropriate assessments. There was an example of 1 relative signing consent on behalf of a person without the person’s ability to consent to this themselves being checked.