Highfield

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 inspection we rated this key question good. At this inspection the rating has remained good.

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

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed and reviewed when any changes occurred. People’s wellbeing was monitored by staff on a day-to-day basis and other health needs were monitored, where needed. For example, 1 person’s overall mood and engagement were monitored so signs of a low mood or withdrawal could be identified which would have a negative impact on the person’s wellbeing.

Whilst most people had either full or some verbal communication, the provider was keen to enhance this with forward planning related to support people’s communication, recognising that this can potentially deteriorate with the aging process. One Polesworth Group Homes staff member had recently completed a Makaton course (basic communication signs for people with a learning disability) and Makaton sessions were offered to people if they wished to take part in these. People spoken with were complimentary about these sessions, telling us they enjoyed them and they were fun.

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.

The provider and management team worked with healthcare professionals to ensure evidence-based care and treatment was provided to people. For example, 1 person was due to have a surgical procedure. Staff understood the importance of supporting the person to understand this and to agree with the plans.

The provider and staff teams worked with specialist learning disability teams and followed their advice and guidance in supporting people to live as independently as possible and do things that mattered to them.

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.

Relatives were very positive about the staff team and comments from relatives included, “Staff are excellent,” and “Staff go above and beyond, I can’t speak highly enough of [staff name].” Relatives felt listened to when they shared information with staff about their relation and involved in their loved one’s support.

One relative told us, “An example of good support was last year when things were very bad. [Name] was losing weight and the GP got involved and they did tests. The hospital was involved. They had a best interests meeting. Everyone was involved. [Name] had lovely support from staff with their investigations.”

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.

The assistant manager told us staff had noticed 1 person was often very sleepy during the daytime and unable to enjoy what they wanted to do during the day. The person had shared that they were online using their ‘tablet’ device during the night and not sleeping. The assistant manager worked with the person so they understood that if they chose to do this during the night, rather than sleeping it would mean they would be tired during the day. Staff had empowered this person to make informed decisions about their online use while promoting their choice, control and wellbeing.

People told us staff would contact the GP for them if needed and support them with any healthcare appointments if they wished for this.

The provider routinely monitored people’s care and treatment to continuously improve it.People and relatives told us staff supported them in accessing healthcare whenever needed.

The management team were aware of the national NHS initiative ‘Stopping Over Medication of People with a learning disability’ (STOMP). This initiative aims to stop the overuse of some medicines affecting the mind, emotions and behaviour.

The assistant manager gave an example of where a medicine had been stopped by 1 person’s GP. Staff then monitored this and evidenced that it had not been positive for this person and their anxieties had increased. The staff team had worked with this person’s GP to re-introduce a medicine to aid the person’s anxiety and improve their outcomes. Another person whose medicine had been reviewed and stopped by their GP had been successful when combined with a move to their current supported living home which offered them a quiet living environment, which met the person’s needs.

The management team were in the process of moving to electronic care planning and told us this would increase levels of recording by staff of people’s achievements and outcomes.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People felt they received the right support from staff and were asked for consent when being supported with personal care or to take their medicines. People were at ease with staff, and we saw staff explain to people what was happening.

The provider had an easy-read Mental Capacity Assessment guide to enable people to understand the importance of decisions being made and consent being given. Care records showed people had been involved in planning their support and given ‘consents’ by signing agreements. For example, 1 person had signed to consent to staff looking after and administering their medicines. Whilst this person was deemed to have the potential ability to self-medicate, they had previously disclosed they may take too many tablets at one time and agreed they would prefer for staff to manage their medicines for them.

Staff told us they had received training in the Mental Capacity Act (MCA) and MCA assessments had been completed when needed. The management team understoodwhen a ‘best interests’ decision might be needed around a specific decision.