Lansdowne Road (67-71)

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 rated inspection (publication date 23 October 2023) we rated this key question Good. At this inspection the rating has remained 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People’s individual care and support needs were assessed, planned for and reviewed with them and or their relative. However, the provider’s systems and processes of how care records were monitored needed strengthening. As described in the Safe key question, guidance for staff about how to meet people’s individual needs was not consistently detailed. This was discussed with the management team who took immediate actions to make improvements including reviewing their monitoring procedures.

People and relatives told us how they were involved in discussions and decisions about how care and support needs were met. People’ s individual care and meeting records, confirmed this.

Staff told us how they were informed of changes in people’s care and support needs via staff handover meetings, information alerts on the electronic care records and during daily heads of department meetings. Record confirmed what we were told.

People’s individual communication needs had been assessed, and staff were given detailed guidance on each person’s preferred methods of communication. Some individuals had limited verbal communication and used Picture Exchange Communication System (PECS), which supports functional communication through pictures. Others relied on nonverbal methods such as body language, gestures, or their own sign language. Staff were observed communicating effectively by adapting to each person’s individual communication style.

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. However, we identified 2 people’s food and fluid support plans were not consistently detailed or their needs such as fluid intake being monitored. This was important to ensure they received safe foods and sufficient fluids as described as required in their care records. No person had come to harm and staff were aware of people’s needs, indicating this was a recording issue. We shared our findings with the registered manager who took immediate actions to make improvements.

People confirmed they had a choice of meals, drinks and snacks and people were complimentary of the choices. A person said, “I really like the food choices.” Two people liked to cook with staff, and we saw records that confirmed what we were told. We observed people making drinks independently and drinks and snacks were offered throughout the day.

The deputy manager told us how the menu had recently been reviewed and a new one developed with the involvement of people using the service. Resident meeting records confirmed this. The food standards rating for the service was a level 5 the highest rating that can be awarded.

The provider’s policies were found to be up to date and reflective of current best practice and legislation. Recognised assessment tools were used such as person-centred planning frameworks and functional behavioural assessments.

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.

Staff worked well together and with external professionals. The provider had effective communication systems for the exchange of information between staff teams.

Staff were positive about the internal communication systems and processes and found these helpful and supportive. A staff member said, “We have good communication, we have staff meetings, handover meetings, a daily heads of department meeting and regular supervision. I think communication is good, the staff team all work well together, we support each other.”

Feedback from external professionals received was positive. Comments included, “The management team are quick to respond to emails and are approachable. Care staff write daily notes that are well detailed.”

People’s care and meeting records confirmed how staff worked with external health and social care professionals to support people to receive consistency and continuity in care.

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 were supported to access health services and screening. People told us how staff supported them to attend health appointments. A person said, “Staff always come with me if I have any doctor or dentists’ appointments.”

Relatives told us they were confident staff knew and understood their family member’s health conditions and needs. This included supporting them to attend health appointments and monitoring their health and contacting the GP or seeking urgent medical attention if required.

People’s health conditions had been assessed and staff had detailed guidance of how to support people with health conditions such as diabetes. We found staff to be knowledgeable, experienced and competent in understanding and managing people’s health conditions.

Care records confirmed how staff worked with external healthcare professionals and how recommendations made were implemented. Health appointments and outcomes and actions were documented. People were supported to access health screening and had an annual health check. People had access to easy read documents to support their understanding of health conditions or attending the GP practice for health screening.

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.

External health and social care professionals where positive how health needs were known and supported.

Where people had mental capacity and made lifestyle choices that could negatively impact their health, staff provided advice, support, and alternative healthy options. However, staff respected people’s decisions and encouraged them to reflect on their choices as part of ongoing decision-making.

People’s support plans were outcome based. Enabling the person to be at the centre of their care and support, ensuring support was tailored to their goals, independence, and quality of life rather than just focusing on tasks.

People attended monthly meetings with their keyworker where they discussed their quality of life long and short-term goals. An example of this was how a person initially wanted to manage their own medication, and this included their medication being in a lockable cupboard in their bedroom. However, this was not successful, and the person agreed for staff to manage their medicines.

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

Mental capacity assessments were completed in line with the Mental Capacity Act 2005 (MCA). MCA assessments and best interest decisions had been completed for specific decisions about a person’s care and support where the person lacked capacity to consent. There was evidence of consultation and involvement with others such as the person’s next of kin and external professionals.

We identified 1 person who was commissioned 2 staff to support them. Whilst the registered manager explained how and when the second staff member was used to ensure staff maintained a least restrictive approach, this was not documented in the associated best interest decision document. We discussed this with the registered manager who agreed further details were required and agreed to follow this up.

Relatives confirmed they were involved and consulted in discussions and decisions about care and treatment needs.

Staff were aware of the principles of the MCA and had received relevant training and had access to the provider’s policy. A staff member said, “We involve people as much as possible and assume the person can consent. If there is any doubt, an assessment is completed and a best interest decision made with others such as relatives and other professionals.”

Our observations of staff engagement with people were positive. Staff promoted choice and sought the person’s consent before care and support was provided.