Access for Living

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 assessment the rating has remained 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 service made sure people’s care and treatment was effective by involving people and their representatives in the assessment and review of their health and care needs. People and their relatives were positive about being involved in the assessment and review process. One relative told us, “We are very specific about what support [family member] needs. The plan is developed with us and we also spend time with each new staff to ensure they understand everything.”

Staff worked in line with legislation and current evidence-based good practice and standards. For example, staff were alert to the risks associated with people’s eating and drinking and worked in partnership with other professionals such as speech and language therapists to ensure there were risk assessments and guidelines in place to support safe eating and drinking. One professional told us, “Staff have been pro-active in following up concerns regarding one person’s eating and drinking and also demonstrate high levels of insight and skill in relation to managing their swallow safety as the person’s skills and needs have changed.”

The service worked with a range of health and social care professionals to ensure people received safe, joined-up and effective care. This included social workers, physiotherapists and occupational therapists. Staff told us they worked well as a team to deliver safe and effective care. Comments included, “The key to good quality support is teamwork” and “We are very lucky, our team communicates well and works well together.” When people were receiving support from multiple agencies there was clear information in place to ensure staff roles and responsibilities were clear. We also saw staff communicated effectively with other organisations when there were issues or concerns about people’s health and wellbeing. People told us staff worked well with other professionals to help people achieve good outcomes. One relative told us, “[Family member] has input from a range of other professionals. There has been input from speech and language, the mental health team and physiotherapy.” Each person had a hospital passport which ensured key information about people was shared with hospital staff if they needed to go into hospital.

The service supported people to live healthier lives. People’s records included important information about their health conditions and instructions for staff on how to support people’s health and wellbeing. Staff kept clear records of all health appointments and advocated on behalf of people to ensure they received the best possible health care. Relatives were positive about how staff supported people to manage complex health needs and stay as healthy as possible. One relative told us, “It’s remarkable how well [family member] is doing given their age and disabilities. Staff are making sure they get to all the right health appointments and stay as active as they can.”

People told us the provider monitored their care and reviewed care and support as things changed. Despite positive feedback we could not see how people were being supported to identify and work towards long-term goals as review meetings were not recorded. We discussed this with the provider and they have agreed to review their practice to ensure they record the ongoing monitoring towards outcomes. Where it was required, staff recorded key information related to people’s health conditions and shared these with health and social care professionals when needed.

People had information about their rights to consent. The staff respected these when delivering person-centred care and treatment. Staff completed relevant training and had a good understanding of the importance of involving people in decisions about their care. The provider consulted with people’s relatives/representatives when people were unable to make decisions about their care and support. However, we found they did not carry out a mental capacity assessment in line with the Mental Capacity Act 2005 when they had cause to suspect one person could not consent to their care and support. We raised this with the provider and they have reviewed their processes and documented mental capacity assessments where necessary. Staff understood their responsibility to seek consent from people wherever possible and act in people’s best interests. A member of staff told us, “Mental capacity means ensuring that individuals are supported in making their own decisions wherever possible. Any decisions made on their behalf is for their best interest if they lack the capacity to decide for themselves.”