An Darach House

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• 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.

People's needs were assessed before they received support and reviewed when their circumstances changed. Care plans contained detailed information about people's health, wellbeing and communication needs and provided staff with guidance on how to support them safely and consistently.

Care plans were personalised and reflected people's preferences, routines and the support they required. Information was presented clearly and helped staff understand how to meet people's needs effectively. Staff demonstrated a good understanding of the people they supported and how their care should be delivered.

The registered manager regularly reviewed people's needs to help ensure care remained appropriate and reflected any changes in their circumstances. We identified some opportunities to further strengthen records by using more positive and person-centred language throughout care documentation.

People received care and support that reflected current good practice and was tailored to their needs. Staff worked with people to understand what was important to them and used this information to plan and deliver their care.

Staff monitored people's health and wellbeing and understood how to recognise changes in their health and wellbeing. Information about people's care was reviewed to identify patterns and early signs that additional support may be required. This helped staff make informed decisions about people's care and respond appropriately when changes were identified.

Care plans provided staff with guidance on how to support people and reflected their preferences, needs and goals. Staff demonstrated a good understanding of the people they supported and delivered care in line with current standards and best practice.

Staff worked well together to provide consistent care and support. Information about people's needs was shared effectively to help ensure staff understood how to support them and respond to changes in their circumstances.

Relatives spoke positively about communication and continuity of support. A relative said, “Staff turnover is low. We have a new key worker. The new key worker shadowed the old one first and they drew up a detailed care plan so the new worker knew exactly what to do. They also called me to introduce themself and I generally call them every other day for an update.”

The registered manager worked closely with external professionals to help ensure people received the support they needed. Staff sought specialist advice when required and worked with healthcare services to support people's health and wellbeing. This helped ensure care remained consistent and reflected people's assessed needs.

People were supported to maintain and improve their health and wellbeing. Staff understood people's health needs and worked with them to promote healthy lifestyles, independence and choice. Relatives spoke positively about the support their family members received to manage their health. One relative told us how their family member had not had any seizures in over 12 months and put this down to the staff’s knowledge and skill in supporting them well. Another relative said, “Staff take [my family member] to doctors’ appointments. They see [other health professionals] too. The nurses know them well.”

People were supported to access healthcare services and attend routine health appointments when needed. Staff worked with healthcare professionals to ensure people received appropriate advice and treatment to support their wellbeing.

People were encouraged to eat a balanced diet, maintain hydration and take part in physical activity. One person attended a local slimming club and had achieved positive outcomes with support from staff. A relative told us, “[My family member’s] key worker supports them to stick to their diet. They look well, healthy and their hair is nice.” Another relative said, “[My family member’s] health condition causes them to eat more. Staff try to offer healthy food choices. They have fitted a new kitchen in the last six months. [My family member] can go in the kitchen and help themself. Staff will help cook the meals. They get a roast dinner on Sundays.”

The registered manager had systems in place to monitor people's progress and review whether their care and support continued to meet their needs and aspirations. Staff regularly reviewed people's goals, achievements and experiences to help ensure support remained responsive to changes in their lives. Monthly key worker meetings provided opportunities to discuss what people had enjoyed, what was working well and any future goals they wished to achieve. The registered manager used this information to update care records and develop individual plans that reflected people's changing needs and preferences.

The provider had recently created a more detailed approach to recording the steps taken towards people's goals and the progress they had achieved. Although this had not yet been implemented, it had the potential to strengthen how outcomes were recorded and provide greater consistency in how staff supported people to develop new skills and work towards their goals.

The registered manager respected people's right to make decisions about their care and support. Staff sought people's consent and encouraged them to make choices about their daily lives wherever possible.

People were supported to make decisions about how they spent their time, what they ate and drank and their daily routines. Staff understood the importance of promoting choice and control and supported people in a way that reflected their preferences.

Staff demonstrated an understanding of the Mental Capacity Act 2005 and the principles of supporting people to make their own decisions. Where people required support with decision making, the registered manager followed appropriate processes to help ensure decisions were made in their best interests and their rights were respected.