Lilibet House

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.

This is the first assessment for this service. This key question has been rated 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 and their relatives told us they were involved with planning their or their family members’ care. People and their relatives we spoke with felt they could talk about their or their family members’ care needs and feel confident in the support provided by staff.

Staff told us they had time to review care planning documents, so they could keep up to date with people’s changing needs. Staff we spoke with showed a good knowledge andunderstanding of how to support people’s needs, and what action to take if the person’s needs appeared to have changed.

Where people’s needs changed, care planning documents were updated so staff understood any new guidance. For example, where a person’s allergies had changed staff were made aware of how to manage any reactions safely. We saw the guidance was incorporated into an updated care plan and risk assessment.

People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people, to have a clear understanding of the person’s needs.

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.

We saw care plan reviews had involved the person and their relatives, if appropriate. Relatives we spoke with told us they were involved with care planning and were kept updated on any issues arising. One relative told us, “Communication with them is unreal … Its so good.”

Staff kept records on how they had supported people and at what time. There was consistency in these daily records for food and nutrition, oral care and personal care. The Registered Manager regularly audited planned care records, to identify and address any concerns or shortfalls.

Staff worked in accordance with best practice principles in learning disability and autism care. All staff had undertaken part one training in learning disability and autism. The registered manager was actively attempting to access part 2 for the team. All staff were aware of CQC’s Right Support, right care, right culture (RSRCRC) guidance. RSRCRC outlines principles of good care and support for people with a learning disability and autistic people. We expect all registered providers providing these specialist services to meet these requirements.

People’s communication needs were clearly recorded, to enable staff to effectively communicate with people. For example, care plans for people who had specific communication requirements were detailed and personalised. Information for staff to support a person’s spiritual beliefs was included within care plans. All staff had training in basic Makaton.

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.

People had clear pre-admission documents in place, detailing their individual needs. The management team assessed their capacity to support people based on the overall dependency needs of the service. The service had a positive relationship with their local authority contracting team. This ensured all potential service users were assessed in a timely manner in order to consider suitability for the respite service.

The service worked well with external health and social care partners and implemented guidance from these teams to support people effectively. Staff felt confident in their positive relationships with external partners. One staff member said, “I enjoy working at Lilibet house and feel supported whilst at work by the staff team and the management team.”

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.

During the assessment we saw people supported in person centred ways to achieve their goals including supporting living healthier lives. For example, people were encouraged and supported to improve mobility and exercise levels with walks in the local community. Other people were supported to access swimming facilities or bowling.

Staff we spoke with told us healthy eating was supported through balanced menus, alternatives for dislikes, cultural considerations and access to foods people preferred. Independence was encouraged through choices and small tasks. For example, making drinks, brushing teeth and preparing snacks.

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's needs were robustly assessed, so their care and support could be delivered in line with current standards. This supported people to achieve effective outcomes. Care plans had clear guidance for staff to follow, to ensure people received their planned care and support during the day and at night.

People were supported to maintain good nutritional intake and hydration levels. The staff understood where people had been prescribed a specific diet to reduce the risks of choking. People and their relatives were positive about the support for dietary needs provided at Lilibet House. Staff we spoke with explained how a person on a very restricted diet had chosen to try new foods whilst staying on a respite visit.

Care plans were person-centred, and detailed people’s skills, life experience and strengths. People and relatives, we spoke with had been involved in regular reviews of their plans of care. People and their relatives were positive regarding staff being hardworking and understanding of their needs.

Families told us the service helped people achieve positive outcomes. They noted improvements in independence, confidence, and general wellbeing. One family member told us, “(persons) quality of life has improved — it gives (person) independence and (person) mixes with peers.”

Relatives told us they were kept fully informed and given reassurance if their family members were unwell or emergency healthcare was sought for them.

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

Staff completed training regarding the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Where people lacked capacity, mental capacity assessments had been completed in line with the legal framework.

Some people at the service were subject to a Deprivation of Liberty Safeguard (DoLS), this is where a person cannot make decisions about their care and treatment, so restrictive care arrangements are legally authorised in the person’s best interest. Staff had knowledge of DoLS and how this impacted people. All applications were awaiting local authority authorisation.

Staff explained how they asked for consent before providing care, people’s right to say ‘No’ was respected and we were told of staff using a different approach or using a different colleague. This meant people’s human rights were respected.