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 71 (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, “I was involved right from the beginning and was part of the assessments and care plans. I can see the care plans whenever I want” and “I was part of getting the place and of getting [family member’s] care plans right, I see them all and am a big part of changing them when needed. We meet often and I feel they are right.”

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.” Staff received relevant training to ensure they had the skills and knowledge to support autistic people and people with a learning disability. Staff told us they were confident in supporting people with complex eating and drinking needs. One member of staff told us, “We get training so we are sure about what we are doing with different methods.”

The service worked with a range of health and social care professionals including social workers, physiotherapists and occupational therapists to support the delivery of safe and effective care. A family member told us, “Staff will get a physiotherapist or occupational therapist on board if they need something for [family member] and also work with whatever the other professionals recommend.” Professionals who worked with the service were positive about the how the provider collaborated and worked in partnership. One professional told us, “Access for living staff are good at highlighting needs. Staff give prompt, carefully considered responses to therapy interventions. There is good, proactive communication and good implementation of guidelines.” 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 care plans 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. Each person was supported to have an annual health check with their GP. Family members were positive about how staff supported people to manage complex health needs and stay as healthy as possible. Comments included, “[Family member] has many health issues and the staff coordinate with everyone. To be honest I don’t know how they do it.” Another family member told us, “Staff are very good at helping [family member] stick to a healthy weight. The staff couldn’t do better.”

The service routinely monitored people’s care and treatment to continuously improve it. There were regular keywork meetings and annual reviews where goals and aspirations were discussed with people and their representatives. Where it was required, staff recorded key information related to people’s health conditions. For example, staff were checking one person’s blood pressure on a regular basis. A manager of the service told us, “We have instigated regular blood pressure checks to help [person] become less stressed about having this done. Hopefully it will also enable us to identify any issues early and get the person more accustomed to having health checks which they find difficult.”

People had information about their rights to consent, 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 made referrals to the relevant authorities when there were concerns that people lacked capacity to make key decisions for themselves. However, they did not record capacity assessments in line with the Mental Capacity Act 2005 before submitting Deprivation of Liberty Safeguards (DOLs) applications. We discussed this with the provider, and they have reviewed their processes. Staff understood their responsibility to seek consent from people. One member of staff told us, “If I had any concerns about someone’s capacity, I would tell my manager and arrange an assessment and best interest meeting if needed.” One health and social care professional told us, “Staff understand people’s individual needs and they are really good at advocating for vulnerable people. They have gone above and beyond in some cases to ensure people’s voice has been heard.”