Virtuous Business Solutions Limited

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.

This is the first assessment for service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

The provider did not always make sure people’s care, and treatment was effective because care planning documentation did not always reflect people’s needs accurately.

Risk assessment documentation was not always sufficiently detailed. For example, some assessments recorded a numerical score but did not explain the significance of the score or identify the corresponding level of risk.

Risks associated with the use of restrictive equipment were not always fully assessed or clearly documented. For example, some people required the use of safety belts whilst seated, however, records did not contain sufficient information regarding the rationale for its use, whether consent had been obtained, or any associated risks. Staff were able to explain how to support the person safely and the reason the equipment was required.

Information about people's health needs was included within care plans, however, information was not always sufficiently personalised to reflect individual circumstances.

People's communication preferences were clearly documented and understood by staff. Care plans provided personalised guidance on how and when individuals preferred to be contacted, helping to ensure care and support were delivered in a way which met their needs and preferences.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Care plans contained detailed information about people's nutritional and hydration needs, and staff demonstrated a good understanding of how these should be met. However, some relatives did not always feel staff had the skills, particularly in relation to meal preparation and the use of kitchen equipment. The provider was aware of these concerns and had taken action to address staff understanding of meal preparation.

Care plans contained clear, step-by-step guidance for staff, including information about staff responsibilities, the use of equipment and how personal care should be delivered in a dignified manner.

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.

The management team and staff knew people well, this helped people to tell their story and have their needs met consistently and safely. Staff shared relevant information and worked with families and external health and social care professionals to ensure people’s needs were understood and their wishes heard.

Internal communication systems supported coordinated working. Staff received operational updates through message applications, electronic alerts and meetings, with important information shared promptly. The provider had also introduced an intranet system where information was shared with staff.

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 were supported to maintain their health and wellbeing through timely access to healthcare services. Staff worked with people to monitor their health and facilitated access to relevant healthcare professionals when required.

Care records contained clear information regarding potential deterioration in people's health and wellbeing. Records provided staff with guidance on the signs and symptoms to look for and the actions they should take in response, helping to ensure people received timely and appropriate support.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

Regular audits of care records, including daily care notes and medication administration records (MARs), were carried out to ensure care was delivered in line with care plans and people's wellbeing was closely monitored.

The provider carried out regular spot checks to monitor the quality of care and observe staff practice. These visits also provided opportunities to gather feedback from people about their experiences of the service, helping to ensure high standards of care were maintained, and any concerns could be identified and addressed promptly.

The provider had not always ensured people were supported in accordance with the principles of the Mental Capacity Act 2005 (MCA).

People and relatives told us, staff sought consent before providing care, and daily records evidenced this, however, the provider had not consistently applied the MCA.

Care planning documentation contained inconsistencies regarding people's ability to make decisions. Capacity assessments were completed where there was no evidence of an impairment. This demonstrated a blanket approach to capacity assessments rather than a decision-specific application of the MCA.

Where people were living with dementia and short-term memory difficulties, records did not always explain how these conditions affected their ability to make specific decisions or demonstrate capacity had been considered where appropriate. Whilst care plans contained information about how staff should support people, the provider could not always demonstrate people's capacity to consent to their care, and treatment had been assessed and recorded in accordance with the Mental Capacity Act 2005.