Sandpiper

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 71 (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 plans and assessments considered people’s physical, mental health, social and communication needs and reflected their preferences. They also included information about people’s life history.

The service regularly reviewed people’s care and support to ensure care plans were up to date. Relatives told us they had previously been involved in people’s care reviews but not recently. We fed this back to the manager, who said they were planning to increase the involvement of relatives in care reviews.

Staff had specialised training in how to support people with a learning disability and or autistic people to meet their assessed needs.

People who had individual ways of communicating could interact comfortably with staff because staff had the necessary skills to understand them.

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 nutrition and hydration needs were met in line with current guidance. When any risks relating to people’s nutrition had been identified there was clear guidance for staff on how to support people. Where people required a modified diet, speech and language therapist (SALT) guidelines were clearly documented in people’s care plans and where food was prepared.
Staff supported people to manage their dietary needs and encouraged them to make healthy choices where possible; guidance was available to staff to assist them. We observed people being independent or involved in meal and drink preparation when they chose.
Documentation showed people were able to go shopping for snacks and drinks with staff support, and drinks and snacks were available to people within the home to access independently.
The service was not regularly recording people’s weight or completing malnutrition risk checks, so changes in weight were not consistently monitored. However, records showed people were supported to get medical help for weight loss or gain, and the manager told us regular weight monitoring would commence.
 

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.
The manager and staff team worked closely with health professionals. Staff were proactive in working with other services to ensure people’s needs were met. This included physiotherapy, mental health and district nurse teams. People had an emergency pack which was used to provide information to health professionals in the event of a hospital admission.
People’s needs and any changes were shared verbally during daily handovers and staff knew people’s needs well. However, handovers did not always document this information in writing.
 

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People had regular appointments with their GP and other healthcare professionals. Staff supported people to attend health appointments and followed guidance to help people manage this. However, the recording of people’s health appointments and their outcomes needed to improve. We found various examples where staff had not recorded people’s health appointments in their care records, or where it was unclear if any required tests to follow up on people’s health concerns had been completed. For example, when people needed urine or stool samples or blood tests it was not recorded if these tests had been completed, nor their outcome. It was unclear if people’s routine health appointments had been rearranged when they had declined to attend. This was important to ensure any information from the appointment was captured, and medical guidance was shared and followed.
We fed this back to the management team. They took immediate action to ensure some of the missing health appointments were added to people’s care records. The manager told us they planned to address the recording of health appointments in a team meeting. They also shared records confirming the concerns raised had been discussed with staff in supervision.

Where people could be at risk of constipation there was not always clear guidance for staff on how to support people. The service had identified this and were working towards ensuring people had clear bowel management plans.

People’s care plans recorded any support they required to maintain physical health. Some people’s care plans incorporated guidance from physiotherapists, and people completed regular exercises to maintain their mobility.
 

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 included outcomes people wanted to achieve in various areas, including personal goals. They included information on how to support people to achieve their outcomes.
Some people had been supported to achieve positive outcomes, for example one person was being supported to lose weight to improve their health, they had lost a significant amount of weight. Staff were working with the provider’s positive behaviour support lead to try to improve another person’s sleep routine.

Staff supported people to have regular meetings, where they were asked questions about their care and support and any changes they would like to make or what they would like to achieve. However, it was unclear how items raised were actioned or followed up, or how people’s progress towards their personal goals were recorded or monitored. The manager told us they planned to further develop keyworker roles for people, and a planned development of the electronic system they used for recording would enable them to have better oversight in this area.
 

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

People’s communication support plans recorded how to share information and support them to make decisions and choices.
Where people lacked capacity to make specific decisions, mental capacity assessments were completed, and best interest decisions made. Relatives and health and social care professionals were involved in these decisions where appropriate. Assessments and decisions were clearly documented. Relatives told us they had been involved in decisions relating to people’s health where needed. The manager had identified where some further assessments were required and told us they planned to complete them.

Staff told us they respected people’s wishes and decisions and our observations confirmed this. A relative said, “Staff respect their decisions they are very thoughtful to their needs and know their temperament, staff know how to treat them and understand them.”