Your Support

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 outstanding.

This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 96 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them. People’s care documentation was exceptionally detailed and person centred. A range of methods were used to ensure people’s needs and wishes were understood. Relatives told us they were consulted regularly about their loved ones. When care needs changed, they were contacted to help contribute to understanding about the best possible options for future support.

Staff teams were observant to any small changes in people. The teams supporting individuals met regularly to share these observations to ensure consistency in any changes of care approach. Assessments considered people’s needs holistically and were reviewed regularly with them to ensure care and treatment resulted in the best possible outcomes.

People’s communication needs were assessed from the point of assessment onwards through their care journey. This helped staff to maximise opportunities to build trust and understanding and help people to feel confident about expressing their needs. Staff we spoke with understood people’s needs well. When a person was not able to express themselves well verbally, staff made incredibly careful observations of their nonverbal communication and used Intensive Interaction techniques to build rapport and better understand the person. This empowered the person to express themselves and meant the staff were able to respond dynamically to the person’s needs.

The provider always 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. They worked to develop evidence-based good practice and standards. For example, the management team ensured the service adhered to the STOMP (stopping over medication of people with a learning disability, autism or both, with psychotropic medicines) initiative. This initiative was introduced by NHS England to support people to live better quality lives without the need for unnecessary or unpleasant medications. The management team also ensured the team worked within the principles of Positive Behaviour Support and were following Restraint Reduction Network practices to reduce restrictive practices.

People were supported to eat and drink well and in line with current guidance. Clear records were kept of what people ate and drank. People were supported to participate in their food shopping and chose what meals and snacks they wanted. In some cases, people had never before had the opportunity to participate in food shopping. The experience added to their sense of independence and autonomy. In some cases, people had progressed with support to be able to prepare a full meal for themselves. Others clearly delighted in the simple pleasure of popping out for a favourite snack.

Detailed assessments were made of people’s needs and preferences around nutrition and hydration. When needed, people’s weights were monitored regularly. A person who was being supported to gain weight to improve their health had done well. Care staff maintained careful records about what foods the person ate well to promote their appetite. This included attention to food textures and colours. Staff also considered which foods were more consistent and less likely to taste different on different occasions, as 1 person disliked inconsistency. People were supported to consider healthy choices, but their wishes and preferences were respected.

When changes were made to people’s care, data was gathered to review the impact of the changes. This meant people benefitted from care which was reviewed and adjusted to achieve the best possible outcomes. Staff told us about training they had received to provide ‘active support’. This was described as care which placed people at the centre of their own care rather than being recipients of it. Staff told us they felt this approach had been very beneficial and the training had made positive differences to the care people received.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The management team worked hard to ensure people received care from a wide range of professionals in line with their needs. They described this as ‘wrap-around’ care. The management team and senior support workers met regularly and, in some cases, very regularly with professionals to review people’s care needs. External professionals spoke very positively about working alongside the staff teams. Regular reports detailing a holistic assessment of people’s wellbeing and activities were shared with commissioners and other relevant professionals. Staff teams also proactively contacted relatives to provide updates about people’s wellbeing. All professionals and relatives we spoke with commended the service for their communication and responsiveness. This meant people benefitted from well-coordinated care provided by professionals working collaboratively.

Careful plans were made to support people to attend external health appointments. People who had not been able to receive health care such as dental care were supported to do so successfully. This was achieved by careful collaboration with external agencies and professionals to ensure people’s needs and wishes were understood and met. This enabled people to live without dental pain and feel confident about attending future appointments.

Staff teams supporting people day to day shared detailed handover information. Daily notes were exceptionally detailed and allowed staff to have a very good understanding of any developing or changing care needs. When people were transitioning to the service from previous care providers, detailed planning was conducted to facilitate this. Plans supported people to adjust to their new support teams and their new homes at their own pace. People were also supported to adjust to changes within staff teams. The management team recognised how difficult it could be to cope when a regular staff member was away from the service. They created story boards and shared information to help people prepare and cope with the changes. They also built in flexibility within the senior support worker team to know a number of people well and understand their needs. Seniors could then lessen the distress of unexpected changes in staffing plans by stepping in but being a familiar face.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

A person had been supported to reduce the number of staff they needed day to day. This reduction represented a huge achievement for the person. Having fewer staff around them was less restrictive to them. The reduction also showed the person how much they had achieved and how much they had progressed. The person was proud of this achievement, and it boosted their confidence.

When a person was noted to be becoming less active and having less energy, staff responded quickly. Staff liaised with professionals about the person’s medication. Changes to the medicines prescribed were agreed and the person began to feel more energised and motivated. Over time they began to show renewed interest in engaging in physical exercise and social activities which they had been disinterested in.

People were supported to proactively care for themselves to avoid deterioration in their health. They were supported to attend eye tests, dental appointments and have medical reviews and tests to monitor their general health and wellbeing. For some people, attending such appointments had been very difficult and challenging previously. In some cases, attending such appointments had been impossible. Where possible staff supported people to develop confidence and value in themselves. This helped people to recognise they needed and also deserved good healthcare. Some people had been supported to achieve changes which were transformational to their quality of life and wellbeing. When early signs of health deterioration were observed, people were supported to address them quickly.

The provider monitored people’s care and treatment to continuously improve these. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. Careful monitoring of people’s wellbeing enabled early identification of potential concerns. This meant that when people experienced inevitable obstacles such as health issues and injuries, they were supported well to cope with them.

People’s care journeys showed all had experienced positive and transformational outcomes since receiving support from the service. For example, one person had been subject to significant restrictions in their previous care home that greatly impacted on their physical health, happiness and quality of life, as well as their co-residents’ quality of life. As a result of the dedicated, personalised and caring support they received from Your Support to manage their distress, they no longer required any restrictions and were now happy and content, enjoying their life to the fullest. All the relatives we spoke with told us about how their loved ones had benefitted from the care they received. One relative told us, “[My loved one] has come on 100% from the day [they started to receive care from Your Support]. I have a photo of the old [version of them]. They are now a different person.” Another relative said, “[My loved one] has improved a lot… We have seen lots of positive changes in their behaviour.”

The management team had developed a system of careful monitoring and recording as well as analysis and review of people’s health and wellbeing. They ensured that key changes observed were shared with the relevant professionals in a timely way. When staff saw positive change and success, when appropriate this was celebrated. The changes were reviewed and shared with the wider team. In this way best practice was shared so that other staff could also support people to achieve better outcomes.

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment. Wherever possible staff supported people to understand care and treatment available to them. People were actively supported to make decisions about their care.

In cases where people may struggle to make decisions for themselves, mental capacity assessments were carried out. Capacity assessments were decision specific. Best interests decisions were made in consultation with people, advocates, relatives, staff who knew them well and health professionals. For example, a person was deemed not to be able to make decisions about their finances. An appointee was assigned to help ensure decisions about how their money was spent were made in their best interests. We saw that capacity assessments and best interests decisions were made in line with the Mental Capacity Act 2005. Staff told us about the training they received to ensure they understood the importance of seeking consent and involving people in decisions. We saw that staff were tested on their knowledge about this.

We saw and records also demonstrated that staff frequently sought the views, wishes and preferences of the people they supported. Staff showed a clear awareness of how people expressed agreement, refusal or uncertainty. They responded accordingly to ensure people remained at the centre of decisions about their care.

Care documentation guided staff about what decisions people could usually make for themselves, and what they might need support with. Records reflected that a person’s ability to make decisions could be impacted by their wellbeing. For example, if a person was feeling very distressed, they would not be able to make decisions about how they could remain safe. Staff understood the need to support people to feel calm and settled to facilitate decision making. We saw that staff respected people’s right to refuse care offered to them. A person who could not verbally express their wishes was supported by staff who clearly understood other ways in which they could communicate refusal or acceptance. We saw many examples of how staff shared information with people to help them understand and make informed choices. This included information tailored to people’s particular communication needs. For example, staff used gestures or visual prompts, simplified language or simply giving people more time to process information.