Nobilis Care Southampton

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 inspection 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 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 was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People told us their care met their needs and reflected their care requirements.

Senior staff completed assessments before care packages commenced. This included visiting people in their home or in hospital to understand their desired outcomes and how they wanted their care to be delivered. Assessments included input from professionals where needed; for example, recommendations from occupational therapists or speech and language therapists (SALT) were incorporated into care plans.

The provider reviewed care shortly after packages commenced to identify any initial issues or required adjustments. Regular reviews followed to ensure care plans continued to reflect people’s current needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider had not ensured guidance for staff on managing people’s conditions clearly reflected the boundaries of their role and responsibilities. For example, 1 person’s epilepsy care plan included guidance for staff on administering rescue medicines in the event a seizure; however, staff were neither trained or required to do this, as it was the responsibility of the family. The care plan did not clearly state that administering this medicine was not part of staff’s role and did not provide explicit instructions for staff to follow in the event of seizure.

Following the inspection, the registered manager provided an updated epilepsy care plan with clearer guidance for staff. In addition, they reviewed the care plans of the 3 other people, using the service who had epilepsy. This included contacting relevant healthcare professionals to ensure the guidance reflected their current needs. This helped reduce the risks associated with the condition.

Staff had a good awareness of the importance of promoting nutrition and hydration. They explained they were mindful to ensure individuals had access to food and drinks outside of scheduled visits, helping to reduce reliance solely on staff support. Where concerns about eating or drinking had been identified, there was evidence these had been reported to the relevant professionals, enabling additional support to be arranged. For individuals requiring specialist diets or modified food textures, care plans reflected professional guidance, and staff showed a good awareness of how to follow this and provide appropriate care.

The provider worked well across teams and services to support people.

There were effective working partnerships with professionals when coordinating care between stakeholders. For example, the provider worked with district nurses to plan and deliver care visits for people who required nursing support to administer their insulin. The provider coordinated this care, enabling district nurses to plan their visits and ensure insulin was administered at the appropriate time.

Professionals provided positive feedback about working with the provider. They told us the provider was proactive and accepted care packages in a timely manner, and appropriately reported concerns and shared updates. This approach helped to promote positive outcomes for people using the service.

Staff told us there were effective systems to share important information across the team. These included communication via the electronic care planning system, as well as regular updates from senior staff when individuals’ needs changed.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

People told us they received effective support from staff to meet their healthcare needs.

People’s healthcare needs were documented in their care plans, including how their conditions affected their daily life and the support they required. Staff demonstrated a good understanding of individuals’ ‘baseline’. For example, 1 person’s care plan detailed their history of recurrent urinary tract infections (UTI’s), including the signs of infection. Staff reported concerns promptly, which enabled timely medical intervention, which reduced any impact. The registered manager maintained clear records of concerns and actions taken, which supported accountability and safety.

Another person living with Alzheimer’s had a care plan outlining their usual presentation and subtle changes in symptoms. The person’s care plan explained how their symptoms could vary day to day and how staff should adapt their approach. Care plans also detailed when to escalate concerns, ensuring appropriate ongoing support.

The provider ensured that outcomes were positive and consistent. However, they did not always ensure quality and accuracy in the recording of care provided.

People told us that staff provided the supported they needed in monitoring their health, medical conditions and wellbeing.

Senior staff monitored agreed care outcomes for ‘bridging’ care packages. For example, when supporting a person to regain their mobility after injury. Progress was shared with relevant stakeholders, including incoming providers where people needed longer term and ongoing care. This helped reduce the risk of unsuccessful hospital discharges. We received positive feedback from health and social care professionals; who told us the provider was pro-active in recognising changes to people’s condition and adjusting support to meet their needs in response.

Systems were in place to monitor care call compliance and flag missed or late visits. Electronic monitoring tracked visit completion, timing, care tasks, and medicines administration. Senior staff analysed this data through audits to assess care effectiveness, identify changing needs, and evidence when adjustments to care packages were required.

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

The provider had effective systems to obtain and record people’s consent. People or authorised representatives signed care agreements. The provider completed checks to confirm representatives’ legal authority to act on people’s behalf. This helped to ensure valid consent was obtained.

Care plans identified when people needed support with decision-making and set out clear, person-specific strategies to help people express their views. Records showed how people were supported to make informed choices.

Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA), including presuming capacity and seeking consent at each interaction. Where capacity was lacking, appropriate best interest decisions were made and clearly recorded.