One to One Plus South

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

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 Requires Improvement. At this inspection the rating has changed to 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 comprehensively assessed and include consideration of their physical health, mental health, sensory, social and communication needs. Care plans were person-centred and included what was most important to people, these focused on promoting independence and minimising distress. The registered managers regularly reviewed care records to ensure they continued to meet people’s changing needs and preferences.

People and their relatives were involved in assessments of needs and the development of care plans. A relative told us, “[Name] has an annual review. We all sit down with [registered manager] to discuss how they are and any concerns we might have. The current concern is about their mobility as they have been more unsteady. What [The registered managers] have done is a full health screening to see if this is having an impact, they have gone above and beyond. Staff are encouraging [name] to mobilise without a trolley so they can maintain their independence.”

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 registered managers worked collaboratively with people, their relatives, and relevant professionals to plan and deliver care. For example, where people had complex eating and drinking needs the registered managers had sought advice from Speech and Language (SaLT) professionals. This was used to inform people’s care and minimise risks.

Staff demonstrated a good understanding of people’s health conditions and learning disabilities and how this impacted their lives. Staff received training and regular updates to ensure that they understood current standards to effectively support people.

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 service

The registered managers worked together with people and services to support a multidisciplinary approach to effectively deliver coordinated, timely, consistent and person-centred care. For example, working with a local hospice team to develop an end-of-life plan to prevent readmission to hospital. A relative told us, “I am reassured that a plan is in place, so that [name] does not have to go hospital. [Staff] knows their likes and routines; they can anticipate their needs and reduce their distress.”

Staff told us that information about people’s needs was shared effectively. The registered managers ensured that staff were updated in handovers and daily notes about any changes in people’s needs so that care could be provided flexibly and adapted as required.

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 involved in planning how their day-to- day support was provided and were encouraged to manage their own nutrition and hydration where possible. We observed staff supporting people to maintain their independence with everyday tasks such as food shopping, meal planning, and cooking. Staff supported people to make healthier lifestyle choices and prompted them to remain active. One person told us, “I like being in the garden, we have a paddling pool for when it is hot and a tent with seating. I like growing vegetables and hope to use them for cooking healthy meals.”

People were empowered and supported to take an active role in managing their own health, care and wellbeing needs wherever possible. Staff encourage people to develop their independence and make choices about their daily lives. For some people this included going out independently to local shops. These opportunities helped people build confidence, develop new skills, increase their sense of self-worth and lead meaningful lives within their community.

Staff understood people well and could recognise and identify changes in them which may indicate if they were unwell or in pain. Care plans contained information about people’s health and well-being needs. These were regularly reviewed and updated. They provided clear guidance for staff.

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.

People were involved in all aspects of their care and worked together with staff to achieve their personal goals. People’s aspirations were individually tailored around what was important to them. For some people this meant staff supporting them to have a ‘good day’ for others this was maintaining long-term employment, which had given them a greater sense of fulfilment. Most people had lived at the service for several years, during this time they had grown in confidence which had helped them to live more independently.

The registered managers and staff knew how people’s past experiences could affect the way they lived their lives. This helped staff to better understand people’s needs, recognise the reasons behind their responses and build trusting relationship. As a result, situations where restraint may have been considered were significantly reduced, as staff were able to use effective de-escalation approaches that prompted people choice, control and better emotional wellbeing. This approach had a positive impact on people’s lives. For some people, the consistent and person-centred support they received meant they were able to successfully maintain a long-term placement in the community which has previously been considered unachievable.

Relatives told us about how their loved one’s lives had been transformed since moving into the service and the personal impact this had on them as carers. One relative said, “I think that [name] is doing very good, they are well cared for and staff understand their needs. I couldn't find a better place that would suit them. [Name] is very comfortable there and that is important to me, I feel relieved that they are happy.”

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

People’s independence was maintained by encouraging them to make daily decision about their activities, tasks, and routines. They choose when and how their care was provided. People were supported by staff that knew them well and could advocate in their best interest.

People told us that their views and wishes were always considered with extra support being given to help them understand their options. The registered managers used easy read consent forms to maximise informed decision making. Staff were aware that people’s capacity to consent could fluctuate and was time and decision specific. Staff used different methods of communication to help people make choices about consent including British Sign Language (BSL), Makaton, and writing.