Edgar Street Residential Home

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 changed to 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 88 (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.

The provider demonstrated exemplary practice in assessing people’s needs. Pre-assessments were completed ahead of people moving into the service to appropriately assess the service could meet people’s needs before placements were agreed. They used a range of recognised tools to ensure they could monitor and recognise any changes in people’s needs. Assessments were comprehensive, person-centred and reviewed regularly. The providers assessments were so thorough that they identified every eventuality to support people’s needs before considering alternative placements. When the need for alternative placements became evident, the provider worked tirelessly with external partners to find the best placement. One professional told us, “They have gone above and beyond for our service user and have worked tirelessly to improve [their] quality of life and advocate for [their] needs. They have worked with various health professionals, taken all recommendations on board, and have attended every meeting/ appointment that has been given, which has been a phenomenal amount!”

Assessments explored people’s personal experiences and life histories. This holistic approach allowed rich and detailed information to be captured. This allowed staff to develop care plans that supported people in non-task orientated ways. Care plans contained robust, practical guidance on the most effective way in which to communicate with people, supporting staff to deliver care that was respectful of people’s choices and responsive to their needs. During our assessment visit the manager and care staff demonstrated their knowledge of people’s communication styles, and we were told how to best engage with people during our visit. This meant people were fully empowered to contribute to the inspection process. It also meant when there were reviews of their needs, people were fully supported to express their views and wants to relevant clinicians.

Wherever possible, people and those important to them were fully involved in shaping their assessments and plans of care. Documentation clearly reflected what mattered most to people and the outcomes they wished to achieve. Managers at the service worked collaboratively with others to ensure assessments were accurate, strongly advocating for people. A professional told us, “I have so many examples of how this service has gone above and beyond.”

People were supported to identify achievable goals, and outcomes were regularly monitored to measure progress and adjust support where required. This collaborative approach meant people consistently received high quality, personalised care that promoted their wellbeing, choice and independence.

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.

Care and treatment was aligned to best practice and tailored to individual needs. Care plans were comprehensive, person-centred, and demonstrated understanding of evidence-based care based on best practice. Care plans included risk assessments, communication styles, background information and clear guidance for staff. Plans were regularly reviewed and updated to reflect changes.

Staff participated in debriefs and reflective discussions, which helped reduce the likelihood of incidents recurring and supported a culture of continuous improvement. People, when appropriate, were included in these sessions.

The manager’s effective application of their learning and knowledge and the sharing of this knowledge within the care team contributed to positive outcomes and helped promote a good quality of life for people.

People exercised choice and had access to sufficient food and drink. People, when able to do so, shopped and cooked for themselves. Information was available in easy read formats to help people make healthier choices around food and drink. People’s refusal to follow health professionals’ recommendations around food was well documented by the service.

When a person’s food choices were identified as having a significant negative impact on their finances, education around alternative, more cost-effective food choices took place. Encouragement and support was provided for them to engage with choices such as ‘fakeaways’ rather than ‘takeaways’.

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.

Transitions between services were carefully planned and coordinated, with arrangements tailored to people’s individual circumstances, preferences and communication needs. This helped ensure transitions were safe, well managed and person-centred. Staff, teams and external professionals worked in close partnership, demonstrating a strong culture of collaboration and shared responsibility. This joined up approach ensured people received timely interventions and consistent, holistic care.

Communication with external partners was proactive and effective. Stakeholders spoke highly about the service and its manager. One stakeholder told us, “I've always found [the manager] to be extremely passionate about social care and about getting the best support for people [they are] caring for. [They are] proactive about staying up to date on regulation and good practice and has good relationships across health and social care.” The manager ensured good practice was shared within their service but also more widely across the sector.

Robust systems for sharing information in a timely way ensured continuity of care and helped minimise risk. For example, to support one person with a move to a new property, a transition they would otherwise have found traumatic, staff collaborated closely with external professionals. Information about the move was presented in a pictorial way with short, simple sentences that the person could fully understand. As a result, the transition was less stressful, and the person moved successfully into their new placement. The same was done when the person returned to the home.
 

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.

People had oral health care plans in place, attended regular dental check-ups and had timers to support them to correctly brush their teeth for the recommended time duration. One person proudly told us about their engagement with a national breast health check campaign they had engaged with, and how they had shared this knowledge with others.

People were provided options and information about their likely outcomes, so people made choices which were right for them. For example, we saw how people had been directly supported by staff to make healthier dietary choices to support them to maintain a healthy weight. We were also told how one person had been supported to re-attend exercise classes to support maintaining their weight, following disengagement with exercise following the loss of a loved one. Staff acted as advocates for people when liaising with other health professionals, enabling people to make genuine and informed choices about their care.

People, when appropriate, had unrestricted access to the kitchen, and could help themselves to food and drink. Easy to read information of ‘The Eatwell Guide’ was available for people. The Eatwell Guide shows people how to eat a healthier diet.
 

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.

Monitoring tools and processed were used to monitor and improve the outcomes of people’s care. People’s outcomes were person-centred, measurable and regularly reviewed.

The provider displayed a good understanding and the application of ‘right care, right support, right culture’. There was consideration to not only people’s behaviours, but how these behaviours may impact others living at the service. We saw evidence that as people’s needs changed, there was pro-active engagement with other health professionals and referrals to appropriate agencies were made.
 

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

Managers and staff upheld people’s rights to help ensure they had maximum choice and control over their lives. People were supported in the least restrictive way possible, and we observed people leaving and returning to the home as they wished. People understood their rights around capacity and consent, and staff promoted people’s right to choose. We overheard one conversation between a staff member and person, where the staff member said, “Well what do you want to do? It’s your decision.”

When making decisions around people’s capacity, staff involved relevant professionals and people to ensure their human and legal rights were respected. When people are assessed as lacking the capacity to make consent to decision around their care and support, an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty.

The provider followed the 5 core principles of the of the Mental Capacity Act 2005 when assessing people’s capacity to consent, including people, those important to them and other appropriate professionals being included in best interest meetings. For instance, being enabled to attend and use non-verbal communication to more meaningfully engage with the process.