Diverse Abilities Plus - Supported Living

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 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. A relative commented on this involvement, "Involved, experience of knowing [person] and what works. [Person]’s listened to, what they want… definitely [involved]."

Assessments comprehensively considered people's physical, emotional and social health and wellbeing, including their communication needs. They reflected people's unique strengths, needs, preferences and hopes for the future. Staff worked with people and their relatives to plan and review care based on these assessments of need. Care plans were up to date. Whilst structured care plan reviews involving people, relatives and professionals took place every 6 to 12 months, there were monthly checks to ensure care plans remained relevant. Care plans were also updated when people's needs changed.

Staff knew people well and understood their care plans, including their communication needs and any support required with this. People and relatives confirmed that staff provided the care and support people needed, enabling them to live in the way they wanted.

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.

People's care and support enabled them to live as they wanted to. It was planned and delivered in line with recognised evidence-based standards and good practice. This included support with eating, drinking and preparing food and drink, where people had swallowing difficulties or dietary needs. Care plans contained clear instructions for staff to provide the required support, with supporting detail available to assist staff in understanding health conditions and dietary needs. Care records reflected that staff followed care plans. People and relatives described their or their family member's care as “good”. A health professional had written a letter following a consultation, remarking on the person being "supported by care staff who know [person] extremely well" and on "how well supported [person] is". The service had received positive feedback from external reviews of the deaths of adults with a learning disability and autistic people.

The provider's systems kept staff abreast of current standards and good practice. This included ensuring staff attended refresher training and discussing good practice in supervision meetings. The registered managers participated in external networks that kept them informed of changes in legislation and guidance, as well as developments locally. They shared these with staff as needed, through channels such as supervision, team meetings and usual communication channels. They also ensured staff attended regular refresher training.

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.

Where people received support from different teams within the service or from external organisations, care was coordinated effectively. The service had received positive feedback about the way staff worked in partnership. Care plans contained contact details for people's health and social care professionals and records of care reflected regular contact with them.

People had up-to-date care passports for use when they went into hospital or received care elsewhere. These summarised what anyone providing their care or support must know, including people's communication needs and what was important to them. The provider's staff had easy access to people's care passports and care plans. They recorded the care provided on a computerised recording system.

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 had the assistance they needed to manage their health and wellbeing. This included staff supporting them to consider their health and wellbeing as part of regular care reviews. Staff were alert to early signs of changes in people's health and supported them to consult a health professional. Additionally, staff supported people to obtain regular healthcare, such as dental check-ups and treatment, eye examinations and annual GP reviews. Staff also supported people to access age and gender-related health screening as they wished or in accordance with their best interests.

Staff supported people to make healthier choices, whilst respecting their wishes and preferences. People told us about active hobbies they enjoyed, such as dance exercise classes. Relatives said their family members had the support they needed with their diet, including "proper meals". Two relatives commented that their family members ate healthy, freshly prepared meals once staff working with them had become more confident with cooking. Care records reflected people having varied diets, as far as their preferences allowed, with encouragement to choose healthy options.

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 consistently experienced positive outcomes that met expectations set out in legislation and best practice guidance. Staff worked with them, and where appropriate their families, to set goals that reflected their ambitions and what they wanted from their care and support. Care plans contained clear instructions for staff about how to support the person towards achieving their goals. Each person's care plan was individual and centred around their needs, strengths, wishes and preferences.

There were continuous improvements to people's care and support. The service routinely monitored people's support and outcomes. This included regular meetings with people to discuss how their care was going, informal conversations with people and relatives, staff supervision meetings, quality assurance audits, complaints and compliments processes and learning from incidents.

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular 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 particular decisions, any made on their behalf must be in their best interests and the least restrictive possible. We checked whether the service was working within the principles of the MCA.

People, and where appropriate their families, had meaningful involvement in care planning. Care plans reflected their wishes and views. People and relatives confirmed staff respected people's choices and asked their permission before assisting them. The registered managers knew how to refer people for advocacy support if this was required.

Staff recognised the importance of seeking consent each time they provided care. They always provided care with people's consent or in their best interests as determined under the MCA. People's consent to care plans was recorded in their care records.

The last inspection found that some records of mental capacity assessments and best interests decisions lacked detail. Additionally, there was no mental capacity assessment and best interests decision for restrictive aspects in relation to 1 person’s care.

Where there were concerns that someone might not understand the implications of consenting to or refusing care, staff now followed the requirements of the MCA. This meant they assessed the person's capacity to consent to that care, in line with MCA principles. Where this showed the person was unable to give informed consent, staff made a best interests decision regarding the care to be provided, including for care that could be restrictive, such as the use of bedrails. Staff involved the person, their family and professionals who knew them well when deciding on how to provide the care in the least restrictive way.