National Care Group Kent Head Office

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 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 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 79 (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 support was effective by assessing and reviewing their health, support, wellbeing and communication needs with them.

There were effective processes in operation to understand people’s needs and wishes before they were offered a service. People and their relatives were given the opportunity to meet other people and staff. An assessment was completed with everyone involved in the person’s support which covered all areas of their life. People met with staff and leaders assessed their interactions to make sure staff could provide the support the person wanted in the way they preferred. There was a transition process for people when they began to receive support. This included visits. The process of transition into the service was taken at the pace of the person.

People’s support plans and goals were kept under review. Leaders reviewed plans annually or when people’s needs changed. People and their relatives confirmed they were involved in the reviews and their views were listened to and acted on.

The provider planned and delivered people’s support 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 provider worked in line with the principles of our Right Care, Right Support, and Right Culture guidance. People’s support plans included person centred goals they wished to achieve and how they would be supported to achieve these. People had nationally recognised Distress and Discomfort Assessment Tools (DisDat), which identified how they communicated distress or discomfort to help staff and health care professionals understand what people were telling them.

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 including, “We have worked with the learning disability nurse and diabetic nurse team around what a person should and shouldn’t eat. We’ve got easy read posters which the person has put up in their room. We work with the person to be independent with their insulin injections making sure we advise but don’t nag. The person checks their own blood sugar levels and if they want cake, we know what to do if their blood sugars go up”.

The provider was committed to delivering a service in line with the ‘REACH’ standards, ‘a set of voluntary standards that introduce the fundamental principles of Support for LIVING’. The aim of the standards is to support people with a learning disability and autistic people, their representatives, and staff explore what a good life would be for the person and how to make it happen. Staff had followed the principles and people were involved setting goals and planning their support to achieve them.
 

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.

Systems were in operation to ensure staff always had up to date information about the support people needed and how they was to be provided. They told us, “Things change, so we get regular training and updates around policies and procedures”.

People had hospital passports in place and staff understood how people communicated their health care needs and when they were feeling unwell. Hospital passports contained important information about people’s preferences, such as if they did not like needles and would not consent to having blood taken or being given injections. This information allowed healthcare staff to plan people’s treatments with them in ways people preferred. Information about risks to people and how these was mitigated was also included, for example, if people were at risk of choking and how their meals and drinks should be prepared to reduce risks to them.

Hospital passports and DisDats were taken to appointments or when people went into hospital, to make sure people received their support according to their preferences. the documents included clear information about people’s health, how they preferred their treatment delivered and how to relieve any anxiety they had around having treatment. Staff told us they had positive working relationships with people’s GPs and learning disability nurses.
 

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 support.

When staff identified changes in people’s health, such as coughing whilst eating, they referred them to health care professionals for advice and treatment. Staff supported people to attend health care appointments, where the person wanted, to support them to share how they were feeling and offer them reassurance. Staff encouraged people to follow any recommendations when they returned home. Such as supporting people to eat a modified diet to reduce the risk of them choking. Relatives told us they were informed of the outcome of the appointments.
People were encouraged to eat healthy. A relative confirmed their loved one’s diet had improved since they had begun using the service. Another told us, “They have a menu up in the kitchen. They have fresh vegetables and make homemade soup”.

People were supported to remain has healthy as possible and were encouraged to take part in exercise. One relative told us, “My relative has a trampoline and an exercise bike which is built into their daily routine”. Other people went for walks in the country, worked out at the gym, went for a cycle on specially adapted bikes or attended judo classes, successfully achieving different belts.
 

Leaders routinely monitored people’s support 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 encouraged and supported to learn new skills. Their achievements kept under constant review to ensure they were progressing and make any changes needed to support people. Staff agreed with people and their representatives when goals needed to be modified to ensure people were safe. A relative told us staff had worked with their loved one to support them to be more independent when travelling and had agreed, “It’s safer to go out with staff as they can’t focus on what they are doing”.

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

People told us they made decisions about all areas of their lives. They explained to us how they chose to spend their time and their money. For example, saving for some things and buying things which were important to them.

Staff understood their responsibilities to support people, when needed, to make decisions. People had been assessed as being able to make day to day decisions and staff provided them with the information they needed. Staff respected people’s choices, including when these were unwise. A staff member told us, “Sometimes this can be frustrating to watch but we can only advise and ultimately it is their choice but I do explain what might be the outcomes”. Staff gave us examples of ways they supported people to remain as safe as possible when they made unwise decisions.

Staff understood when they needed to work with people, their relatives, advocates, social workers and other professionals to make complex decisions in people’s best interests. Relatives told us they felt involved in making decisions in people’s best interests. One relative told us, “Meetings can be held at any point. If any decisions come up they will have a meeting to discuss things”.