City 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 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.

There were regular reviews of people’s care to ensured it continued to reflect their needs and wishes. This included ensuring care was supporting people to achieve the things that were important to them, such as remaining independent, staying in their home and participating in their culture. People and their relatives were involved in these reviews, which happened routinely or in response to their changing needs or wishes. People’s care could be updated or changed at any time, and one relative told us, “I’m in touch with the provider regularly so can mention things at any time and they will make changes if needed.”

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.

There was clear information about what best practice care was for each person, which was documented in people’s care plans and staff could confidently explain. Where people’s health had changed, the provider had worked with professionals to review if the guidance needed to be updated to ensure people’s safety. For example, there had been a choking incident, and staff had contacted speech and language therapy (SALT) as a precaution to check if updated eating and drinking guidance was needed.

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.

There was a small team who knew people very well and were able to provide a consistent level of care that was tailored to each person. This allowed them to form close and trusting personal relationships with the people they supported. One relative explained, “I do like the consistency of staff which is very reassuring for both my relative and ourselves as family, that they are being supported by staff who know them very well.”

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.

Staff worked together to support people in remaining healthy, including through managing any complex health needs together with them. For example, one person had diabetes and staff explained how they would support them through appropriate meal planning and ensuring they remained hydrated. The provider also supported people’s emotional wellbeing through companionship which supported people to have the benefits of social interactions and build positive and affirming connections with staff. One relative told us, “Having company is very important to my loved one and it keeps them engaged. I’m really happy with this element of the care.”

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.

There were systems in place to monitor people’s care, including formal care reviews as well as regular checks. The registered manager would frequently call people to check their wellbeing, and if anything could be improved. Where people were at risk through their health conditions, monitoring systems were in place to ensure these were well managed. This included regular checks on people’s skin to ensure it remained healthy, and that people were having enough to eat and drink. We received feedback that staff knew people very well, so were quick at identifying when something wasn’t right. One relative told us, “If staff notice any concern, then they will make us aware straight away which puts our minds at rest”.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Although it was confirmed that people were central to their care and involved in any discussions or decisions, we identified some paperwork had been signed on their behalf by others. This should not have been taking place as people had capacity to make decisions for themselves; however, this had not been recognised by the provider. All those we spoke to emphasised the ability of people to make individual decisions for themselves and that their wishes would be respected. One staff member told us, “(Person) can tell us exactly what they want so we make sure to respect that.” A relative added, “Absolutely my loved one is involved in all decisions. We meet together as a family with them and the provider and review this together.” Staff were trained and knowledgeable about the principles of consent, and we saw these were being followed in practice. After the assessment, the provider met with people to review consent arrangements and ensured documents were signed by the correct people.