Ann 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 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 service assessed and reviewed people’s health, care, wellbeing and communication needs with them. However, this was not always done consistently.

One person had specific needs to promote their individuality and wellbeing. However, information to guide staff how to support them with this was not included in their care plan. This meant there was a risk the person would receive inconsistent support.

We received mixed feedback from people’s loved ones about how they were kept updated and involved in their assessments and reviews. One relative told us, “I get nothing from staff, and I would like to know more about what [person] does.” Another relative told us, “[Staff] run things by me, and I am involved in [person’s] care plan. There is a multidisciplinary team involved.”

The service ensured care, treatment and support was delivered in line with legislation and current evidence-based good practice and standards.

Staff supported people to have enough to eat and drink to prevent malnutrition or dehydration and supported them to manage their dietary needs and associated risks. One relative told us, “The staff are good at knowing [person's] likes and dislikes and monitor their diet. There is nothing they could do better."

Where people had diet and fluid charts in place, these were completed, as required. Where people had swallowing risks, guidance was available to guide staff how to manage these.

We saw an example of how staff responded to a swallowing incident. This was recorded appropriately, interim support was put in place, and a referral was made to the appropriate professional within the organisation. The provider was in the process of updating their triage and referral process for concerns related to swallowing.

The service 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 told us they worked well together. One staff member told us, “You get the usual niggles but, in the main, we are united and work well as team.”

Staff recorded and discussed information about changes in people’s needs, and this was shared with the rest of the team. The management team ensured any tasks such as appointments were followed up in a timely way.

The staff team worked well with external services. One health and social care professional told us, “The team is very good. They are involved in people’s care and attend meetings and reviews.” Another health and social care professional told us, “I find the service is very open, and very responsive.”

The service 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.

We saw evidence the service sought support from healthcare professionals when they identified people could benefit from this. When people were unwell, records showed that staff facilitated access to the GP quickly.

One relative told us, “[Person’s] quality of life has improved. They eat and sleep well and are much less anxious. I very rarely get any calls about their behaviour now.” One staff member told us, [Person’s] wellbeing and physical health has really improved since we supported them to access medication to (manage a health condition).”

People had access to dental health care, when required, and attended routine appointments.

The service 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.

Where people had specific health conditions, care plans included information to guide staff how to identify symptoms or issues and when to escalate concerns to specialist health professionals.

People were supported to maintain a good quality of life and to achieve positive outcomes. Staff identified 1 person could benefit from fewer restrictions as these caused behavioural incidents. Staff used a gradient approach to reducing restrictions to ensure the person was not placed at too much risk or a risk to others. Through using this approach, and monitoring the person’s progress, behavioural incidents reduced and the person’s wellbeing increased with more independence. In relation to this person, 1 health and social care professional told us, “The service drew up a plan, and gradually lessened restrictions in a safe and manageable way.”

One relative told us, “[Person’s] quality of life has improved. They have become more confidant to do things independently.”

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

People are supported to access independent advocacy, and advocates were appropriately involved by the service. One independent advocate told us, “Staff support [person] well, and are led by what they would like.”

People’s records contained detailed assessments of their capacity to understand and make decisions about their support. Where people did not have the capacity to understand and make decisions about their support, there were records of decisions made in their best interests.

We observed staff seeking people’s consent about their care.