Enigma Clinical Solutions Ltd

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 assessment we rated this key question requires improvement. At this assessment the rating has changed to 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 provider assessed and reviewed people’s health, care, wellbeing and communication needs with them. However, some information was not accurately recorded or clear. For example, one person’s assessment stated they were at risk of seizures but this was not always clear in other documents and another person’s assessment described a mobility aid they did not use. We highlighted this to the registered manager who took immediate action to review assessments to ensure they were accurate and reflected people’s needs.

Most relatives said they had seen care plans or copies were available in the person’s home. They had been involved in assessments as required. One relative lived far away but told us they participated in assessments and reviews via video call.

Care plans and risk assessments were developed using information gathered during initial assessments. These showed that a wide range of needs had been assessed, including physical, health, wellbeing and communication needs. Staff told us they had access to care plans and risk assessments and read these regularly.

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 provider used current and relevant clinical tools to monitor and review people’s needs. For example, records included assessments of nutritional needs, pressure care requirements and a falls assessment. These helped staff support people in line with their identified needs and evidence based practice. Where some records were missing detail, we highlighted this to the registered manager. Following the inspection the registered manager reviewed people’s care plans and risk assessments to ensure they were up to date and accurately reflected their needs.

Care records included information about people’s nutrition and hydration needs, including their level of independence with associated tasks. A choking risk assessment was routinely carried out to provide guidance to staff. When staff supported people with eating and drinking, individuals were offered choice and respected people’s preferences.

The provider worked 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.

We received mixed feedback from professionals about how staff worked in partnership with them. They told us, “Communication can be inconsistent and sometimes delayed and collaboration is not consistently strong”, although a professional also said, “In some instances, staff are committed and responsive.”

Effective systems were in place to enable staff to communicate with each other and managers. Staff told us these were helpful and enabled them stay up to date. This included via calls and messages, staff meetings and reviews with stakeholders.

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.

Most people managed their own health needs or were supported by family or friends if needed. Staff supported people to attend appointments or make healthy choices as required. For example, some people were supported to have a low salt or heart-friendly diet.

Care plans contained information about people’s medical conditions and health needs. Staff told us they would report changes in a person’s needs or health to the registered manager for advice or action as necessary.

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.

Care records included clinical monitoring tools and these were regularly reviewed. Staff told us any changes to people’s needs were shared with the registered manager and other staff who supported the individual. Most people’s relatives had been involved in reviews, although some had not been using the service for long enough for this to have happened yet.

Most people and their relatives felt the support they received from Enigma Clinical Services met their needs and helped improve their health and wellbeing. One relative told us, “I am very satisfied. As far as we are concerned, they do a very good job.” Relatives were clear that they would speak with staff or managers if expectations were not being met.

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

People and their relatives told us their views and wishes were considered and staff sought consent before supporting them. Staff received training in the principles of the Mental Capacity Act 2005 and put this into practice when they supported people. At the time of our inspection, no-one was subject to restrictions under the principles of the Mental Capacity Act 2005.

The provider had systems in place to support effective decision making if people lacked the mental capacity to make their own decisions. People’s consent was recorded in care records. When individuals lacked mental capacity to make specific decisions, this was documented, their relatives or supporters were involved and any decisions which had been made in people’s best interests were clearly recorded.