Adult Pathways 1

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 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 requires improvement. At this assessment the rating has changed to 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 and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Systems were in place to ensure people’s needs were fully assessed before moving into the service and detailed initial care plans were developed. People and their loved ones had the opportunity to visit and build relationships before making the decision to move to the service. A family member spoke positively of the transition process and told us, “We had meetings with house leaders and that bit felt wonderful. [We felt] [Name] was going somewhere that cared. They were professional and they were suggesting good things we had not thought of. We had comprehensive meetings/conversations, and I was really impressed with the way they talked to [Name]. The staff were all very welcoming, introduced [Name] to other people in the house etc. We were very, very involved.”

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. Care plans had been developed with guidance from other professionals. Staff received training and guidance around people’s specific care needs. This included training which enabled staff to effectively respond to people during emergency situations caused by health conditions.

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. Referrals were made for people to other health and social care professionals when needed. Referrals were appropriate and made in a timely manner. A healthcare professional described a recent review of a person and told us, “[The registered manager] and staff were very efficient, supplying the records that I requested promptly. The records were of a good standard and showed me what I needed to know. The staff were very knowledgeable about the person's needs.”

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. We observed people were offered nutritious and healthy food at mealtimes. Several people received nutrition and hydration via a Percutaneous Endoscopic Gastrostomy (PEG). Staff received detailed training and people’s weight, and general health was closely monitored. We observed people using the grounds of the campus to walk and cycle. The provider had several adapted bikes available for people to use and take exercise.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or they met both clinical expectations and the expectations of people themselves.

Some people had independence related outcomes identified in care plans which were very brief and had not been reviewed for some time to ensure they were appropriate or to check progress was being made.

Some staff were not always completing records consistently so, at times it was difficult to establish if staff had provided routine care. For example, repositioning records were not always recorded in the same place. For one person who was prescribed a thickening agent added to drinks to reduce the risk of choking, staff were not recording the amount of thickener added, or if the person refused to have this in their drink. There was no evidence of people experiencing poor health outcomes for example, poor skin integrity or episodes of choking but we shared our findings with the registered manager. The registered manager assured us action would be taken to raise this with staff and would put measures in place to monitor records more closely.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Decisions were made in line with the Mental Capacity Act 2005 (MCA). Detailed records were maintained. When a person could consent to care, this was appropriately recorded and reflected through risk assessments and care plans. We observed staff asking and explaining to people prior to any care intervention.