California 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.

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 83 (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.

Staff developed personalised care and support plans using their electronic care planning system. This included detailed information about people’s individual needs relating to their physical, psychological, psychosocial and emotional wellbeing. People had positive behavioural support plans (PBS) which assessed behavioural triggers and warning signs, proactive and reactive strategies, escalation responses and post-incident debrief. These were reviewed and updated in line with people’s needs.

Staff updated assessments and care plans for those people who received regular short-term respite care to ensure these accurately reflected their care and support needs prior to coming into the service and upon their arrival.

Staff gathered information to inform their assessment which included input from people, their families and health and social care partners. This provided a holistic view of care and support needs.
 

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. Staff worked to develop evidence-based good practice and standards with guidance from specialist practitioners and in line with legislation.

Staff worked collaboratively with people and their health and social care partners to ensure guidance and recommendations were incorporated into care, treatment and support plans. This included guidance from specialist medical teams, nurse practitioners and therapy services. Some specialist care plans were also written in an accessible format to aid people’s understanding. This provided a current and up-to-date evidence-base for care and treatment plans which people were aware of and informed about.

People were fully involved and supported with their eating and drinking needs. People led on menu design, grocery shopping, budgeting, and meal planning and preparation. People had access to information about healthy food options and were actively encouraged to choose foods which supported their goals and objectives.

People enjoyed taking ownership, developing life skills, social interaction and choices associated with their mealtimes. Some people had experience of food from overseas travels which they used to vary their diet and share with others. One person had completed a food and hospitality course which staff had supported, and they were encouraged to keep up these skills by taking the lead in managing the kitchen and coordinating the dining experience for people.

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.

Staff shared key information between services using tools such as information passports and two-way diaries. This supported care continuity, improved communications and reduced distress when people attended unfamiliar settings.

Staff worked effectively with a range of health and specialist professionals. A healthcare professional told us, “The service is a great and active multi-agency partner.” Another reported, “Communication with the service is excellent and any issues are raised timely and appropriately.”
 

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.

People accessed healthcare services and complimentary therapies to support their wellbeing. Healthcare professionals also attended their home to meet with them. This flexibility improved outcomes for people who may otherwise have declined to attend services.

Staff supported, encouraged and empowered people to engage in activities to enhance their wellbeing and quality of life. These included outings to the local pub, shopping trips and leisure facilities. Some people also took part in educational, occupational and volunteering opportunities which gave them a sense of worth.

One relative told us, “Despite having a profound disability, one of the things they do well is get them out to do things and give them different experiences.”
 

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Care plans were used to monitor goals and there was evidence of these being reviewed with people to improve outcomes. There were established processes where people required an immediate medical assessment or urgent treatment.

Staff used several other initiatives to monitor and improve outcomes for people.
The ‘Because I Care (BIC)’ initiative was implemented so staff and those they cared for could record a particularly impactful outcome for them. These were shared at team meetings.

The provider also used a ‘Milestones’ initiative where staff recorded positive outcomes for people who achieved their goals or key steps toward a longer term goal.
There were several examples of how this had made a difference to the care, wellbeing and outcomes for people.

One person had lost contact with their community and became increasingly isolative following the COVID lockdown. They had found it difficult to fully reintegrate. Through effective joint working, staff agreed several small short-term milestone goals to improve health, wellbeing and to rebuild connections.

Staff supported another person to engage in a weight loss programme which saw significant improved health outcomes, personal pride and increased self-confidence.
Another person was supported by staff to develop communication skills which reduced distress, improved communication and relationships with people they cared about.

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

Staff had a good awareness of the principles underpinning 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 take decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.

When community deprivation of liberty safeguards were approved by the Court of Protection, this was appropriately recorded and evidenced in the person’s care plan.
People had their personal choices and preferences recorded in their care plan. Staff supported people to make decisions by providing time, using helpful communication aids and visual prompts. A relative said, “They always explain things to them.”

Staff respected people’s decisions and always acted in their best interests.