Listonshiels

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 newly registered 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 83 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, well-being, and communication needs with them.

The provider demonstrated an exceptionally consistent, personalised and holistic approach to assessing, planning and delivering people’s care. This ensured people’s quality of life, outcomes and independence were maximised.

This highly individualised approach began with people’s transition into the service which was exceptional. Comprehensive assessments were completed prior to admission. Staff worked with each individual, sometimes for several months in their previous environment, while they developed a detailed and bespoke transition plan. The person’s needs were paramount and a carefully planned and tailored approach was adopted to ensure a smooth transition into the service for each person. This involved a multidisciplinary approach with supporting professionals as well as the person and their family. The transition process was kept under review and adapted to meet the person’s individual needs. A relative told us how this exceptionally, personalised approach had benefitted their family member, ensuring the move into the service was as smooth as possible and enabling them to build trust and confidence in staff.

People’s support plans and risk assessments were highly comprehensive, person-centred and robust reflecting people’s past histories and any exposure to trauma. This included bespoke positive behaviour support and communication plans which clearly outlined individual triggers, preferences, and effective de‑escalation techniques. They were created collaboratively and tailored to each person with their views and opinions reflected, listened to and acted on. Staff recognised some behaviours of concern can be a form of communication. This was explored in positive behaviour support reviews which enabled staff to identify patterns and modify plans to better meet the individual’s needs and minimise behaviours by reducing or eliminating triggers.

This consistent, holistic approach to assessing, planning and delivering care meant people’s quality of life, outcomes and independence were maximised and often exceed expectations.

The provider always 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. They worked to develop evidence-based good practice and standards.

The service implemented the right support, right care, and right culture guidance. Staff were aware of national guidance and recommended approaches and were focused on delivering individualised person-centred care for people. Staff told us they received support and training to meet people’s needs effectively.

Training was regularly reviewed and updated to meet the needs of people using the service. This included Oliver McGowan training, which is the government’s preferred and recommended training for learning disability and autism, as well as Assess, Respond, Care (ARC) training which is specifically designed to develop skills and knowledge for staff supporting people with complex needs associated with learning disability and autism. This included positive behaviour support and the principles of proactive support and least restrictive and last resort strategies. This meant people received support tailored to their individual needs which was delivered consistently to them by a staff team who were trained to do so.

The registered manager understood and followed the principles of stopping over medication of people with learning disability, autism or both (STOMP). They ensured people were involved in regular medication reviews with professionals and had worked with the community learning disability team in successfully reducing the use of antipsychotic medication for some people. The registered manager told us new medication prescribed for 1 person had significantly improved their quality of life making them more alert and able to participate.

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.

Staff were pro-active in making referrals to health professionals when needed and worked collaboratively and effectively with other professionals to help achieve desirable outcomes for people. This included the community learning disability team, GP, epilepsy team, telemedicine and Speech and Language Therapy (SALT). Staff supported people to attend external appointments and ensured they had essential information with them. This included their hospital passport detailing their communication style, mobility and health needs, along with their risks and presentation during periods of emotional distress. Arrangements were also in place for professionals to visit people at the service if this was better suited to the person’s needs. On occasions, CCTV had been used to enable professionals to observe and assess an individual without causing them unnecessary distress. For example, a health professional was able to observe and assess a person’s eating and drinking while the individual was in their own apartment supported by staff.

We received positive feedback from professionals. One professional said, “When in discussion with [management] about key areas for support I can see they are very passionate and knowledgeable about people. When sharing ideas, the management team use their knowledge of the person to think outside the box for strategies and possible solutions.”

Effective communication systems were in place to ensure staff were kept up to date about any changes in people’s care and support. Staff said communication amongst the whole team was very good and they were always informed of any changes. Updates were clearly recorded on the electronic care system so staff knew if people’s needs had changed.

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 supported people to be as involved as possible in managing their health and wellbeing needs. This included accessing health and social care support from professionals and taking part in regular reviews.

People were actively encouraged and supported to make healthier choices. For example, due to weight concerns, 1 person required support to make healthier choices around food. The person and their family were involved in a multi-disciplinary meeting with a dietician where a structured token system was agreed to support and encourage healthier choices, and provide clear, positive reinforcement while maintaining appropriate limits. This collaborative and best-interest approach promoted least restrictive practice and focused on improving health outcomes and quality of life.

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

The provider had highly effective systems in place to monitor progress and improve people’s outcomes. Staff regularly reviewed how people were feeling, reflected on recent progress and agreed small, achievable aims and goals. This supported people in building confidence, developing new skills and working towards outcomes that were meaningful to them. For example, staff encouraged and supported 1 individual to access the community by going out for a ride in the car. The person responded positively, which led to several outings, including visits to a bakery, which further increased their enjoyment. Previously, the individual had declined opportunities to go out and showed little interest in activities. This represented a meaningful and positive outcome for the person in their community engagement and daily life.

Regular reviews of care, audits, reflective practices and goal setting ensured people’s outcomes were consistently monitored. The management and staff team were consistently striving to improve the service and make things better for people supporting them to try new experiences.

The management team monitored outcomes closely, identifying trends, celebrating achievements and ensuring any barriers to progress were addressed quickly. This structured and proactive approach meant people received support that remained person‑centred, effective and aligned with their ongoing development.

The provider had effective systems in place to ensure the service operated in accordance with the Mental Capacity Act (MCA) 2005. Staff were trained and demonstrated a clear understanding of MCA principles. Where there was reason to doubt a person had capacity to give consent, MCA assessments were completed and best interest decisions implemented. Records we reviewed were very well recorded, demonstrating people’s feelings, beliefs and values were considered.

Staff consistently respected people’s rights around consent and ensured decisions about care were made in a way people could understand. Staff demonstrated a clear understanding of the importance of gaining consent before providing any care or support, in line with the expectation that people receive information in a way that is meaningful to them and have appropriate support to make informed decisions.

Some people at the service communicated non-verbally. Staff understood and were skilled in interpreting people’s preferred communication styles. People’s communication plans provided very detailed information about each individual’s body language, gestures, expressions and responses so staff could assess whether people were happy to proceed with care. Staff understood what hesitationor uncertainty looked like for each person and adapted their approach accordingly.