46 Bath Road

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 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’s care and support needs were assessed before they moved to 46 Bath Road. An admission policy and procedure were in place for staff to follow. The service coordinator told us they accompanied the registered manager to assist in the assessment process to ensure they could meet the needs of the new person. There were opportunities for the new person to visit 46 Bath Road to ensure they liked the home and the people they were going to live with. A relative spoke positively about the assessment process and said, “It was a smooth transition and their relative had settled in well to live at Bath Road.”

People's health, social, sexual, spiritual and emotional needs were continually assessed and when people’s needs changed, their care plans were amended.Staff confirmed they had access to information enabling them to support people in person centred way and these were kept under review as people’s needs changed.

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 management team and the staff fully understood ‘Right support, right care, right culture’ guidance and supported people in line with this. For example, people were actively involved in the planning of their care and setting monthly goals. People told us about the varied activities that took place including going to a church coffee morning, going to the local shops, regularly going for walks and social clubs.

Staff received training in line with Skills for Care and accredited with the British Institute for Learning Disabilities. Staff had completed nationally recognised specialist training for people with a learning disability and autistic people, which aims to provide the health and care workforce with the right skills and knowledge to provide safe, compassionate and informed care to autistic people and people with a learning disability.

People’s nutritional and hydration needs were met in line with current standards and evidence-based guidance. Professional advice had been sought where concerns had been raised with swallowing and choking risks.

Staff demonstrated a clear understanding of the guidelines and procedures in place to ensure individuals remained safe. Some individuals were supported to maintain their independence by using specialist cutlery, enabling them to eat without assistance. Staff worked collaboratively with 2 individuals, alongside a dietician and the speech and language team, to promote a varied and healthy diet tailored to their specific needs.

People had enough to eat and drink to prevent malnutrition or dehydration and were supported to manage their dietary needs and associated risks. People confirmed they were involved in the planning of the menus on a weekly basis. People’s care plans included what they liked and disliked and the support they needed with eating and drinking. This included any known allergies. People spoke highly of the food and the choices that were available to 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.

Staff reported that there was effective communication within the team, which was also observed in practice as staff worked together to support individuals and meet their needs. Staff confirmed daily handovers took place at the beginning of each shift, ensuring they were kept up to date with any changes to individuals’ care and support requirements. This enabled staff to plan their work effectively. There were also clear shift plans in place outlining daily routines and expectations, including responsibilities for household tasks.

A health professional reported that staff were consistently well prepared for meetings and demonstrated a strong knowledge of the individuals they supported. They stated that staff were able to identify subtle changes in people’s health and wellbeing, enabling them to respond promptly. For example, staff were able to recognise early signs of infection and take appropriate action to ensure individuals received timely support.

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 were supported to attend annual health reviews with their GP, and they had access to screening as an early detection of preventable diseases. Routine appointments were arranged for people to attend a dentist, podiatrist and optician appointments. People had oral care plans which detailed what support people needed to maintain good oral health alongside attending appointments with the dentist.

Relatives told us and people’s care records demonstrated they had been supported to access relevant health services, including the GP, neurology, speech and language. A relative told us, “The staff are excellent at keeping me updated, and I am asked if I want to go to any healthcare appointments.”

Two people were supported to access aromatherapy as part of their care, which helped to promote relaxation and enhance their overall wellbeing. This personalised approach demonstrated how staff considered alternative and therapeutic interventions to support people’s emotional comfort and quality of life.

Staff had completed training in Recognise early soft signs, Take Observations, Respond, Escalate (RESTORE). RESTORE is a physical deterioration and escalation tool used primarily in care and nursing homes. During the visit to the home, 1 person had been unwell, and staff promptly completed the initial observations checking on the person. They were compassionate and clearly explained to the person why they were completing the observations. This was then discussed with the GP. A health professional told us, “The staff are really good, they know people well enabling them to recognise promptly when a person is not well and escalate to the appropriate health professional.”

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 care plans were regularly reviewed and monitored. Relatives told us they were involved in their relative’s care reviews on an annual basis. A relative told us, “The staff know (name of person) really well, they know what he likes, his interests and take him to places they know he likes.” Staff confirmed they had access to the care plans and risk assessments, and these reflected the care and support people needed.

People had a designated keyworker, who was a named member of staff responsible for supporting and advocating on their behalf. Monthly meetings were held between the keyworker and the individual to discuss any concerns, review their care and support, and identify any improvements that may be required. This ensured that individuals remained involved in decisions about their care and that their needs continued to be met effectively.

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

People's care was provided in line with the principles of the Mental Capacity Act 2005 (MCA). Staff took people’s views and wishes into account when their care was planned. People’s care plans clearly detailed their wishes, choices and preferences. One person’s care plan described how they could make small decisions, but larger ones need to be done in their best interest involving staff, professionals and family. This needed to be clearer in respect of what constitutes a small or large decision. This was fed back to the service coordinator and registered manager who provided assurances this would be reviewed.

Staff were observed seeking people’s consent before they were supported and offered choices such as how they wanted to spend their time and what they wanted to eat.

Staff had received training in the MCA and were able to describe to us how they ensured people were involved and provided with choices, and they respected people's decisions within their day-to-day life.