Elite Support Providers 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

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent
 

This service scored 54 (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 did not always make sure people’s care and treatment were effective because they did not always ensure care needs were accurately reflected in people’s care records.
Although documentation was in place regarding 1 person’s moving and handling needs, we found the documentation contained differing descriptions of the person’s mobility. Some records described the person as unable to weight bear and fully wheelchair dependent, while others referred to recent supported weight bearing and walker use. Clear, up-to-date records are necessary to ensure staff have a consistent understanding of assessed needs and risks.
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We found one person had been assessed by Speech and Language Therapy (SALT) as requiring IDDSI Level 2 thickened fluids. Records available at the time of assessment contained some conflicting information regarding thickener requirements, although the provider also held more recent SALT guidance and a support plan which clarified the person’s fluid needs. Staff spoken with during the assessment told us thickener was not always used when supporting this person. This meant the person was not always supported in line with prescribed evidence-based care and treatment and was exposed to a risk of avoidable harm
 

The provider worked well across teams and services to support people.

Staff told us they felt supported to provide care and treatment to people. One person said, “We get support from the management and the staff. You call them or message them; they will help you any time. There is someone always available for you. The manager is available 24/7, to give instruction to the staff.”

One professional told us, “Communication with professionals, families, and commissioning teams has been open and effective. The provider has engaged constructively when challenges have arisen, maintained care planning and record-keeping processes, and worked collaboratively with partner agencies to support positive outcomes.”
 

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Staff told us how they supported people with their meals and to engage in physical activity including playing football in the nearby parks.

While the provider had dysphagia guidance and support plans in place for 1 person, these were not consistently implemented in practice. We observed food being offered which did not meet the person's IDDSI Level 6 requirements. Records reviewed also contained examples of foods requiring modification or further assurance to meet the assessed diet.As a result, the provider could not demonstrate people were consistently supported in line with their assessed dysphagia needs, placing them at risk of avoidable harm.
 

We found systems and processes were in place to monitor people's fluid intake and clinical needs. However, records were not always completed consistently or robustly enough to demonstrate effective review of outcomes. This meant the provider could not always demonstrate that people's clinical goals and outcomes were consistently reviewed and evaluated.

The registered manager told us they worked with people diagnosed with PICA to develop their understanding around which items were safe to eat. The registered manager told us they had monitored this and seen improvement in people’s understanding of their condition.
 

The provider did not always ensure decisions about care and treatment were made in line with the Mental Capacity Act 2005 (MCA).

At the time of the assessment, we found external MCA, Best Interests and legal authorisation processes were in place for some people. However, the provider did not ensure capacity assessments were completed for each restrictive practice which we identified at the time of the assessment. For example, 1 person using a wheelchair was observed with a lap belt. Another person using the service had an epilepsy audio monitor in place. We found people were subjected to one to one and two to one staffing at home and in the community. The provider confirmed they had implemented this.The registered manager shared these documents with us after the assessment; however, they did not demonstrate these were always time and decision specific and reviewed. This did not ensure the assessments were meaningful and accurate. This also did not demonstrate the provider and staff had good knowledge and understanding of the process and MCA legal framework