Seven Steps Support Limited

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. This is the first assessment for this service. This key question has been rated 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People's needs were assessed and care was planned and delivered in line with those needs. People and, where appropriate, their families were involved in planning and reviewing their care and support. Comprehensive assessments covered all aspects of people's health, wellbeing, communication and support needs.

The service placed people at the centre of assessing, planning and delivering support. Staff took time to get to know each person, understand what was important to them and learn about their goals, interests and future aspirations.

People were actively involved in assessing their needs and shaping their support. Staff developed a detailed understanding of what mattered to each person and used this to inform care planning and reviews. This went beyond identifying care needs and captured people’s strengths, aspirations and what they wanted to achieve. For example, one person was supported to work with a local university to help students and professionals better understand what it is like to live with a learning disability and Williams syndrome. This enabled the person to share their experiences, increase awareness and understanding of disability, and make a valued contribution to their local community. As a result, they developed greater confidence, self-esteem and independence, while influencing how others viewed and understood people with learning disabilities.

Staff demonstrated an in-depth understanding of each person’s unique communication needs and consistently adapted their approach so people could understand information, express themselves and be heard. Individualised communication methods, including social stories, visual aids, easy read information and personalised communication profiles, were embedded in people’s support. This had a demonstrable impact on people: accessible information enabled people to better understand what was happening and reduced barriers to their involvement; personalised communication approaches enabled people to express their choices, preferences and wishes in ways that were meaningful to them; and people were empowered to use their voice to influence decisions about their care, daily routines and the outcomes they wanted to achieve. As a result, people had greater choice and control and were active participants in decisions affecting their lives.

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 registered manager demonstrated a good understanding of key guidance and best practice.

Before people received a service, a comprehensive assessment of their needs was carried out with the person, family or others who knew them well. Evidence-based tools were used to identify and assess any risks related to falls and nutrition/hydration. From this, a personalised care plan was developed tailored to each person's individual needs, which was reviewed and updated as they changed.

People were supported by staff who had received relevant and good quality training. Staff followed and applied their learning. Training included communication tools, positive behaviour support, human rights and restrictive interventions. Best practice and keeping up to date with guidance on complex conditions was seen as key to ensuring the most effective service for people. Staff undertook a range of training to help deliver evidence-based care. Staff told us training was helpful. Staff regularly met with the management team to discuss their work and best practice.

The provider worked highly effectively across teams and services to ensure people experienced coordinated and person-centred care. Staff shared relevant information appropriately, so people did not have to repeatedly tell their story, and professionals had the information they needed to understand people’s individual needs, preferences and risks. Care plans, risk assessments, health and hospital passports and individual communication profiles supported continuity when people accessed or moved between services.

Partnership working was proactive and responsive. Staff identified changes in people’s needs and communicated these promptly, enabling relevant professionals and services to work together and intervene at an early stage. For example, when one person’s mobility deteriorated, staff responded promptly and worked with physiotherapy services to arrange an assessment. Following professional recommendations, a wheelchair was obtained, enabling the person to continue accessing their community and maintain their independence.

Transitions, including hospital admissions, discharges and changes in support, were coordinated around the individual, with important information following the person. Families were involved and kept informed where appropriate. This reduced the risk of delays, fragmented care or people’s needs being overlooked and meant people experienced continuity and received the right support at the right time.

This collaborative approach had a demonstrable impact on people’s experiences and outcomes. People benefited from timely access to specialist support and coordinated responses when their needs changed. Effective information sharing helped ensure their communication needs, preferences and risks continued to be understood, resulting in safer, more seamless support that promoted their health, wellbeing and independence.

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 experienced coordinated healthcare support, timely access to professionals and positive physical, mental and emotional health outcomes. Staff worked closely with GPs, the Community Learning Disability Team (CLDT), Occupational Therapists, Physiotherapists and other health professionals to ensure people received timely and appropriate healthcare support. Referrals were made promptly when concerns were identified, with staff sharing relevant information and supporting people to attend face-to-face appointments.

Professionals commented on the empathetic and supportive way staff worked to achieve good outcomes. One professional said, “On one particularly important occasion, staff identified mild leg swelling which was subsequently diagnosed as a deep vein thrombosis (DVT). Their vigilance and prompt action potentially prevented a much more serious outcome. Examples such as this highlight the significant positive impact they have on the health and safety of those they support.”

Following the death of a person supported by the service, staff recognised the impact of bereavement on the emotional wellbeing of people who had important friendships with them and provided sensitive and respectful support. People were given opportunities to pay their respects and attend the funeral if they wished. A review of the person’s care specifically acknowledged the ‘excellent care, compassion and support provided by staff.’

The service also invested in staff knowledge and skills relating to dementia care. Staff completed a three-week dementia programme alongside ECHO dementia training and used reminiscence books and photographs to support people living with dementia. Where people’s needs changed, staff sought specialist advice to ensure support remained responsive to individual needs.

People were supported to develop personalised coping strategies for managing anxiety. Staff introduced mindfulness techniques, guided breathing exercises and relaxation sessions using calming music to help people recognise triggers and manage emotional wellbeing more effectively. One person said, “When I feel anxious, I try to find a process to deal with my stress like mindfulness and music and talking to staff.”

One person experienced significant emotional distress following the sudden death of a family member. Staff recognised the impact on wellbeing and worked with the community learning disability team to secure therapeutic support. Although bereavement counselling was not available, alternative home-based therapy was arranged, resulting in a noticeable improvement in emotional wellbeing and outlook.

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.

The provider had a robust approach to monitoring the effectiveness of people’s care, treatment and action was taken to continuously improve it. Staff monitored and evaluated outcomes related to people’s health and quality of life. Staff worked with people to achieve established goals.

Care records showed people achieved positive outcomes that reflected their interests, strengths and aspirations. For example, one person had developed a wide network of friendships, taken part in community-based projects, contributed to training initiatives and become a respected advocate for people with learning disabilities. This had increased their confidence and enabled them to make a valued contribution to their community and the lives of others.

Staff supported people to achieve outcomes that went beyond their immediate care needs. People’s progress and achievements were actively monitored and used to develop further goals and opportunities. People developed friendships, gained new skills, volunteered and pursued creative and enterprise opportunities, with some progressing to advocacy, training and influencing positive change. This demonstrated sustained development in people’s confidence, independence and sense of purpose. People were enabled not only to achieve personal outcomes, but to build on their achievements and take increasingly active and valued roles within their communities.

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

People made their own choices and decisions on a day-to-day basis about what they did, what they ate and how they filled their time. The service was skilled in how it obtained people's consent for care and treatment, adapting their approach to suit individuals needs and involving them in related decisions and assessing capacity when needed. People had tailored communication plans in place for staff to follow to make sure people were in control of their own lives. Staff communicated with people about their choices using objects of reference, pictures, sign language, and electronic aids. This enabled people who did not use verbal communication, to tell staff how they wanted to spend their day. Records included information about people’s capacity and how, either through verbal or non-verbal means, they were able to refuse or give consent for specific decisions.