Endurance Kent- Broadstairs

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

People were supported to make decisions and be in control of their lives. People attended healthcare appointments and were supported to receive treatment.

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. There were effective processes in place to assess people’s needs to make sure the service could meet people’s needs. Before people started using the service, they had a face to face meeting with the registered manager, with support and in a place they were comfortable.

The assessment process included all areas of the person’s support including the hours of 1:1 support. The accommodation on offer is shared, part of the assessment is to look at if the person would be compatible to live with the other person. There was a transition process for people when they moved into the accommodation. This included day visits and overnight stays, people would then be offered the choice of keyworker based on their needs and interests. The process of moving into the accommodation is taken at the pace of the person.

When a person’s needs could not be met by the service, the provider’s other services would be considered and offered as an alternative for consideration.

People’s support plans and goals were kept under review, keyworkers reviewed plans at least monthly or when people’s needs changed. Staff worked with people’s GPs to review their medicines regularly.

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. Each person had a support plan which included nationally recognised tools such as Malnutrition Universal Screening Tool (MUST) to identify risks and guidance to reduce the risk. Staff had followed the guidance in the tools including referrals to healthcare professionals.

People’s support plans included person centred goals they wished to achieve and how they this would be supported. People were supported to manage their health conditions such as diabetes following national evidence based guidance. Staff told us how they supported people to follow guidance and adapted their routines to help with this.

The provider worked well across teams and services to support people. The service worked with other professionals across all aspects of people’s support. Staff made sure health professionals were kept informed of what other professionals had prescribed, or action taken.

Staff had negotiated systems with professionals like the district nurse, so people were supported. For example, one person did not like having their injection from staff. A system was in place for the district nurse to give the injection, and a non-invasive procedure was agreed to enable staff to monitor the person’s health. Other people had complex health needs and staff co-ordinated their health support including having professionals come to their home as they were more comfortable with this.

People had hospital passports in place. These were taken to any appointments or when people went into hospital, to make sure people received their support according to their preferences.

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 explained to us the healthy choices they made around meals. One person explained how they had low sugar options as they were diabetic and ate brown bread, “Because it is healthier.” They told us how staff had supported them to understand their blood sugar levels. The person and staff used the same process to lower the person’s blood sugar such as drinking water and going for a walk. They told us how they had requested money rather than chocolate for Easter, this was better for them, and they were saving up for something.

People had access to an optician and dentist. People were registered with dentists which specialise in supporting people living with learning disability. People’s confidence to go to the dentist had been built up over a period time. The dentists had worked with staff and people to decide the least restrictive options reducing the need for sedation to complete any work.

Some people had a gym membership, they had completed training around healthy diets, some people had attended weight loss classes.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Staff knew people well and understood how to support them in situations which may cause them anxiety. Staff had liaised with the GP to support a person with regular blood tests. The person chose which staff member they wanted to support them along with a family member and numbing cream was applied to the area. This process had transformed the person’s experience. Another person had a good understanding of their various medical conditions but could become very anxious when going to appointments. A system had been agreed whereby they booked all the transport etc. and then checked with staff it was correct. They had also requested staff to go with them to give them confidence as they know staff will advocate for them if needed. They also discussed the appointments afterwards to make sure the person understood what had happened and they were happy with the outcome.

Staff had helped people build people’s confidence to go for health checks. People were now confident to go to the dentist with staff support as they were now less anxious. People went to a local optician who used pictures for people who could not recognise letters when testing their vision.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood their responsibilities to support people, when needed to make decisions. People receiving support from the service had been assessed as being able to make day to day decisions. People told us they made decisions about all areas of their lives. They explained to us how they planned their meals with staff and shopped for them.

People were assessed as being safe to go out unaccompanied. However, some people preferred to go out with staff for reassurance. When people made unwise decisions, staff supported them by making sure they were as safe as possible. Staff told us “If they want to do it, we will find the safest way to do it without restrictions.”

Staff had completed best interest decisions when complex decisions were needed such as moving or having surgery. When people did not have family to support and advise them, professionals who knew people well, were involved to make sure the decision was in their best interest. Staff used videos, easy reads and information from reliable sources such as the NHS website.

Staff understood how people’s moods and emotions could affect their capacity to make decisions. Staff completed capacity assessments following conversations with people to record their advanced decisions. For example, a person knew they would make certain decisions when they were feeling unwell, such as not being taken to hospital. The person recognised this was not a decision they would make if they were well. Staff had informed them when they lacked capacity, and they would act to keep them safe.