Selborne Mews

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 67 (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’s systems to assess and plan for people’s care were not consistently effective. The provider told us there was a system in place to assess people’s needs and put a care plan in place to meet them. They also told us they completed reviews regularly, however there was limited evidence to demonstrate reviews were consistently completed. During a review of peoples care records we found a number of instances where reviews had not been completed for a number of years or there was no date of review. This meant people were at risk of not having their needs consistently re-assessed.

However, the assessment and care planning process did involve people and included transitional plans to support people to move into the home. Staff adapted their approaches to ensure people were supported safely while maintaining independence.

Support plans were created to reflect individual needs and included 24-hour plans that summarised essential information to make them accessible for staff. One-page profiles were also used which summarised key information about people’s preferences, communication, and goals.

The provider made sure that care, support and treatment was based on relevant national guidance, standards and evidence-based practice.

Support plans were available for staff and contained information on how to provide care to the people they supported. For example, staff were supported by a Positive Behaviour Support (PBS) consultant who visited regularly, made changes to care plans and provided training and advice tailored to the individuals living at the service. This helped to ensure that strategies were consistent with recognised evidence-based practice in behaviour support and positive risk management.

The provider made sure that staff, teams and services worked together effectively to deliver safe and consistent care.

The provider worked collaboratively with local authority disability teams, commissioners and therapists to adapt plans, review risks and amend care plans where appropriate. These partnerships ensured people’s support was informed by expert advice and external oversight.

Within the service, staff communication and teamwork was supported by structured systems, such as handovers and team meetings.

Relatives told us communication with external professionals, such as social workers and commissioners, usually worked well. A relative told us, “The staff are good at linking with the community team and letting us know what is happening.”

This demonstrated that the provider ensured staff worked cohesively within the service and with external professionals, supporting consistency of care and safe outcomes for people.

The provider made sure people were supported to achieve their goals and live healthier lives, with care tailored to promote independence and wellbeing.

Staff worked with people to identify and pursue meaningful aspirations. For example, people were encouraged to take part in community activities that promoted both physical and mental wellbeing. This included supporting attendance at local gyms, trampolining, skating, and dance classes. Where necessary, adapted risk assessments and additional staff support were provided so that people could take part safely. Staff also encouraged people to try new activities within the service, such as using the gym, henna painting, and other social events.

Relatives told us they were pleased their family members had opportunities to do more for themselves. A relative told us, “They’ve really helped [my relative] grow in confidence.”

Health needs were supported through access to professionals such as disability teams, therapists and healthcare services. Staff received training in specialist areas such as epilepsy and diabetes and worked with professionals to manage health-related risks effectively. People were supported to attend health appointments, and records were maintained to ensure continuity of care.

This demonstrated that the provider promoted independence, supported people to achieve their aspirations, and enabled them to live healthier lives with the right balance of safety and autonomy.

The provider did not always make sure outcomes for people were consistently monitored or that documentation reflected the most up-to-date information, which risked staff working with unclear or outdated guidance.

Documents were made available to staff to capture what people wanted to achieve and the progress they had made. These included both short-term goals, such as attending a spa weekend, and longer-term aspirations, such as developing independent living skills. Staff told us they used daily notes and outcomes records but told us that reviews were not always timely. A staff member told us, “We write things down every day, but the reviews don’t always get updated.”

We found documents such as decision-making reviews, universal assessment plans, and Herbert protocols without clear review dates, meaning it was not possible to evidence when they were last updated. Daily notes were maintained but were not always clearly aligned to the most up-to-date support plans.

This showed that while staff supported people to achieve outcomes and adapt care in practice, weaknesses in the documentation and review process meant the provider could not always demonstrate that outcomes and associated risks were consistently monitored and recorded to the required standard.

The provider made sure that people were supported to give informed consent to their care and treatment, and that decisions were made in line with legislation and guidance.

Staff and leaders demonstrated an understanding of the principles of the Mental Capacity Act 2005. Social stories and therapy input were also used to help people understand and prepare for decisions, particularly where changes might cause anxiety or distress. Staff told us they worked with families, advocates and social workers to make sure decisions were in people’s best interests when they were unable to make these decisions for themselves. Relatives told us they felt included in decisions and that staff respected people’s rights.

Where people needed independent support, advocates were involved to help people understand their rights and express their views.

Records showed that decisions and consent processes were documented, the approaches in place demonstrated that staff sought to empower people to understand and participate in decisions about their care wherever possible.

This showed that people were supported to give informed consent, and that decisions were made with respect for their rights, dignity, and independence.