Agincare Enable Limited (Wiltshire and Swindon)

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 key question since the provider changed. This key question has been rated outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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. We saw evidence of regularly updated and reviewed care planning documents which changed in line with people’s needs.

The registered manager assessed people’s needs before they started using the service to ensure their needs could be met. The provider also assessed people’s behavioural needs so that people could live in appropriate environments. Staff told us they received good information about people’s needs. Detailed care plans were in place and staff developed risk assessments in partnership with people so that they could take positive risks.

However, during the onsite visit, we observed photographs of a person, who used a wheelchair, enjoying activities but noted there were no footplates on the wheelchair. We asked the service manager about this and they informed us that when stationary the person rests their feet on the floor. On review of the person’s care documentation, we noted there was no information recorded to indicate this preference. The service manager told us they would address this.

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.

People told us staff provided good support for them to prepare meals and drinks. Staff completed regular training in nutrition, food safety and infection prevention and control to ensure their knowledge was up to date. People cooked meals for themselves and took part in house events such as take away nights and group cooking for Sunday roasts.Some relatives were complimentary of the provider and praised the changes the provider had made to support people’s independence. One relative said, “I feel I can relax now knowing my [family member’s] needs are met”. Another relative we spoke to said “ I know my [family member] is safe”. This meant that some relatives had built a relationship of trust with the provider.

However, one relative told us their family member did not receive a welcome pack and spent the first six days wandering around confused due to being new to the service. The provider informed us they were aware of this and they were in the process of reviewing what happens when someone moves into a home following this situation.

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.

We saw evidence of the provider working closely with relatives. Care plans were accessible for staff and the provider used a mobile phone app so that information and updates could be checked at any time.

When additional support from external agencies was required, we saw evidence of good communication and partnership working. The community team for people with learning disabilities had engaged with the service to ensure people’s changing needs were assessed. This meant people did not need to leave their homes as specialist support was in place which provided a wider support network for people.

People told us staff worked well with other services, such as community nurses, GPs and speech and language therapists to ensure they received the care they needed.

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 escalated any changes to people’s health to the registered manager or service leaders.

One person told us they had a medical condition which involved food. They said staff had been supporting them to understand what portion control was and how they could manage it better independently.

Another person told us they had been experiencing memory problems and staff had helped them to “go to appointments for help”. They also told us staff had helped them to understand these problems and that they now have a book for their memories.

Action was taken to contact relevant healthcare professionals and make sure people had reviews if needed. Staff engaged with dieticians and speech and language therapists, and we saw healthy options for food being discussed and supported by staff.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes for people were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff maintained records of the care provided, including whether people’s needs were changing. Records demonstrated changes were shared with healthcare professionals where needed.

The provider maintained records of team meetings and meetings with people and detailed actions to ensure people were receiving effective support. This was evidenced by viewing the monthly team meeting notes the service had recently held. We saw that some people had said they can become unsettled when accessing the community independently if, for example, a journey on public transport did not go to plan. People were then invited to talk about and share their concerns. People were then supported to make their own ‘in case of emergency’ cards so they could feel less anxious while out and about.

During our onsite visit, a person told us they were going on holiday in August and that they wanted to learn French. Staff then prompted them to tell us what they had been learning. The person started speaking to us in French and told us staff had been teaching them so they could speak some French when they arrived in France.

The registered manager told us they regularly checked care records and completed observations to make sure support was provided in a person-centred way. This included regular auditing.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People told us staff gained their consent before providing any care for them.

One person told us staff had worked with them to agree to some restrictions to keep them safe. They were at risk of throwing their clothes away so the provider had introduced locks on their wardrobe. The person was asked in a time and place that was right for them and which helped them consent to this. They told us in their own words why this decision was right for them and why they had consented to it.

Staff demonstrated an understanding of the Mental Capacity Act and what consent means. We saw staff check with people before helping them with meal preparation. Staff understood the need to follow the best interest decision making process if people were assessed to lack capacity to consent to a specific decision.

Staff spoke to us about least restrictive measures and gave examples of how they were thoughtful in their support of people. They said they asked for consent and checked to ensure people were happy with the activities provided.

Staff supported people to understand consent and how to keep them safe. People spoke about and showed us how staff promoted safe dating and relationships.