Anro House

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 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.

Assessments were up-to-date and staff understood people’s current needs. People’s care needs were routinely reviewed when required and, in all cases, on a regular basis. Assessments considered each person’s health, care, wellbeing and communication needs to support the best possible outcomes and these were updated in people’s care plans.
People , along with their relatives and relevant health and social care professionals, were involved in assessments. This helped ensure individual preferences and needs were understood and met. We saw that care plans were regularly reviewed by keyworkers and the Registered Manager to ensure they accurately reflected people’s current needs.
When asked about assessing needs a relative told us “It’s annually, I am invited, I can make suggestions. I used to see the care plan when I requested it, last time I went I wanted to see it, they went digital and they couldn’t give me access. I think it was a new system, when I call the Manager, they update me”. The registered manager told us they would contact relatives to provide guidance on accessing peoples care plans.
 

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.
Care plans thoroughly documented how people should be supported holistically. People’s physical, health, and mental health needs were clearly identified to support them as individuals. Staff and leaders were encouraged to learn about new and innovative approaches, supported by evidence, to improve the quality of care provided.
Care plans reflected individual preferences, including what and how people liked to eat and drink. For example, one person preferred to eat with their hands, while also being supported, when they wished, to develop skills in using cutlery through a hand-over-hand approach. People’s hydration and nutritional needs, weight and bowel movements were regularly monitored to maintain their health, safety and wellbeing.
Care plans recorded when people showed a lack of interest in eating or drinking, prompting consideration of possible underlying health issues, such as dental concerns, along with clear guidance for staff on the actions to take.
Leaders regularly reviewed people’s health and made referrals to healthcare professionals when needed. For example, one person was referred for a health condition and appropriate support was put in place to manage this safely from local health care professionals and staff.
 

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 spoke positively about their Registered Manager and colleagues and how they worked together to ensure that people received good care. Staff could access information on people’s specific support requirements and were trained on how to do so. Leaders held monthly team meetings which provided up to date information on how to support people and their health and social needs, as well as business requirements. Staff told us that when people’s needs changed, they were kept informed through a variety of different ways – meetings, verbally by managers and colleagues and in an action book. One person’s relative told us “He has regular check-ups with the community nurse, dental and GP check-ups.
We observed a staff handover where specific concerns and plans for the day were shared between the two shifts. All staff spoken to, including the Registered Manager, said the staff and people who lived there were like a family. Staff told us all staff have a good relationship and work well together and that they enjoyed working for the service and spoke fondly about the people who lived there.
 

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 access to external healthcare providers in the local community, such as GPs and district nurses, who supported individuals with their health conditions.
People were encouraged to take part in health-related activities where possible, including walks into town and along the beach. Activities were varied and engaging, with a focus on mental wellbeing and community participation, such as playing pool in a local pub.
The Registered Manager and staff told us people were supported to have a balanced diet, while also being able to choose other foods such as hamburgers when they wished. People were asked each week what they would like to eat, however they could make a different choice if on the day they wanted to eat something else.
Care plans documented dietary assessments, preferences and the level of support required. For example, some people required a textured diet due to a risk of choking, with clear guidance in place for food preparation and safe eating support. Staff were able to explain how to support people who were at risk of choking and knew the texture and size of food required and that people were monitored when they ate to ensure that they were safe.

We saw activity planners which showed people taking part in outdoor and community-based activities, including beach walks, gardening, and visits to local activity centres. On the day of inspection, two people visited a local beach, where they enjoyed walking and exploring the surrounding area.
Staff also shared examples of responsive support, including one person who attended a activity and chose to stay longer because they were enjoying the experience.
One relative told us: “They’re pretty good with their diet. They will help them make choices.”
 

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.
Care plans were regularly reviewed, and concerns were closely monitored and amended when people’s needs changed. For example, one person who was underweight when they moved to the service had gained weight, although staff advised this remained an ongoing area of support.
Care plans alerted staff to be aware of changes to people’s appearance and behaviour which could indicate a health or wellbeing concern and actions that should be taken. Concerns about people’s wellbeing were identified and referrals made, where required, to other professionals.
Staff and the Registered Manager told us they encouraged independence in people and gave an example of a person that had since moved to independent living because of guidance and support of the service.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
Where necessary, people with legal authority or responsibility made decisions within the requirements of the Mental Capacity Act 2005. People’s capacity was assessed and where appropriate a rationale was documented as to why they lacked it. Where possible the service worked with people’s families or alternatively consulted an Independent Mental Capacity Advocate (IMCA) when best interest decisions were needed.
We saw that best interest decisions and Deprivation of Liberty Safeguards (DoLS) authorisations were made where required. These were clearly documented, with detailed rationale explaining why they were necessary and how they were in that person’s best interests. We saw people were asked consent in ways that they could understand. When staff needed to support people or wanted to engage them in activities, they used various methods to communicate such as Makaton, written word or images. Where people did not wish to participate, we saw that people were empowered to make those decisions which were respected. For instance, staff told us people were involved in making their beds each day, but it was when they wanted to do it, if at all.
Staff understood the importance of consent and empowered people to have choice. Staff were able to explain their actions if a person refused to take medication in a sensitive yet safe way.