Portland Road

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 outstanding. At this assessment the rating has remained 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.

People’s needs were robustly assessed prior to them moving to the service. Staff and the management team took time to get to know people when they initially moved into the service. This information was shaped into a risk assessment and care plan, which highlighted how each person wanted to be supported and what was important to them. Where possible, staff worked closely with the person, their relatives and external professionals to build a clear picture on what support a person would need. People were able to visit the service before moving in to ease any concerns that they may have around this. The registered manager was also mindful of the people already living at the home, to ensure they would not be unsettled by the process.

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 management team and staff had a thorough understanding of appropriate legislation and kept abreast of best practices. A staff member told us, “We are always doing training, that creates the backbone of how we can deliver great care for people. We sometimes have to handle challenges, especially when people are experiencing periods of extreme unwellness. Our training keeps us grounded as a team and gives us different avenues to explore to best support people. Not everything works for everyone.” Another staff member said, “The resources are brilliant. We’re always learning, and [registered manager] is always encouraging us to do different things. Everyone is confident, we’re not doing it alone, and we can use our knowledge to work with people to promote an excellent standard of care.”

Staff and the management team used their bespoke training in innovative ways to support the people using the service. For example, staff had undertaken ‘Hearing Voices’ training. A course which helped them understand the impact of hearing voices and how this should be acknowledged rather than supressed. Staff and the management team then took this learning and developed a ‘training’ session for people living at Portland Road. People could attend this session to create ways to manage their voices and establish robust methods to minimise these. One person used the knowledge gained from this training to hypothetically ‘squash’ their voices between their hands. They did this each time the voices got worse, and this significantly reduced the distress they experienced because of this.

Care plans were developed using robust assessment tools and were regularly reviewed to incorporate new evidence and recommendations. Staff used approaches such as ‘Wellness Action Plans’ or ‘Trauma Informed Practice’ to create care plans that were important to people. Staff had access to a comprehensive library of clinical resources and legislation, with access to emerging care models, particularly in relation to mental health support. Staff had regular robust competency checks, alongside a supportive coaching and mentoring supervision programme provided by external professionals.

Staff worked collaboratively with healthcare professionals, including GPs, mental health teams and other specialists, to ensure continuity of care and adherence to clinical pathways. Feedback from external professionals was extremely positive and showed the home’s strong commitment to improve people’s lives with excellent care delivery.

The provider worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once. This approach had helped a number of people with seamless transitions to more independent living and promoted a positive care experience for people, by reducing anxiety and stress of change.

Staff facilitated flexible care for people to ensure their needs were understood without any delay. They worked closely alongside services to enable a robust care package was in place specific to people’s individual needs. One professional service provided feedback stating, ‘The staff are kind, responsive and are successful at delivering a high standard of care to all the residents under their roof. They maintain close contact with us and support us with the provision of our conditionally discharged patients, by keeping us closely informed of any changes in their presentation. Our team are appreciative of their support and most importantly, all of our service users who are placed at Portland Road are all very happy to be there'. Another professional, who had worked with staff at the home to support a person move to more independent living, said, ‘It's stood out to me how brilliant your efforts have been to advocate for and assist [person] with all the complexities involved. They are lucky to have had such a brilliant and committed team surrounding them for so long, as I'm sure all other residents are.’

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

There was a strong emphasis in people’s care plans which focused on enhancing the quality of people’s lives. This was delivered in a widely varied and often innovative way. Staff supported people to think outside of the box in terms of improving their health. For example, one person had been hearing voices, and this was having a significantly debilitating effect on their day-to-day life. Staff worked alongside other professionals to establish that whilst medicines were partially effective, more was needed to provide distraction and a creative outlet for this person. As such, they were linked in with a local creative writing group and an art group. This provided an artistic outlet for the person to express how they were feeling which guided staff with how to interact and engage with them. Some of the artwork this person produced was included in an exhibition at a local community space. This gave them a huge sense of pride and had a significantly positive impact on other aspects of their lives as they could manage their voices which aided socialisation.

People’s care was shaped using SMART [Specific, Measurable, Achievable, Relevant, and Time-bound] goals which meant these were realistic and measurable for people. One person was disengaged with meaningful activities and was spending a lot of time in isolation. A keyworker diligently worked alongside them to establish any cause for this. It was agreed that the person would keep a sleep diary for a number of weeks, which led to it being established that their sleep pattern was negatively impacting on their mental health and daily motivation, especially in the mornings. Staff worked with the person to use a sleep aid at night and develop a more structured daily routine, including applying for a local allotment plot to aid more physical activity. They were also supported to access a local walking group. This all created a vast improvement in the way the person was sleeping, and in term improved their mental health, developed their fitness and supported them to maintain a healthier lifestyle.

People were supported to access health professionals when needed. The service strongly advocated for people to receive health support which had previously been unavailable to them. This supported people towards a better quality of life.

People pursued a variety of hobbies, and the staff respected these interests, planning staffing levels and outings to accommodate them. Staff also used their existing knowledge and skills to support people. For example, one staff member provided meditation classes for people. The feedback regarding these from people was extremely positive and they spoke about the improvement in their physical and mental health as a result.

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 and staff were exceptionally outcome focused. A strength-based approach was used to support people develop their individual care plans. This looked at what skills a person already had, and the person worked with staff to formulate their own plan around these to improve other areas and work towards more independent living. For example, one person lived with diabetes and had previously been told they were not able to manage this safely. Staff worked alongside this person and supported them to complete a food diary, including information about emotions around mealtimes, for a couple of months. By doing this it was established that they found cooking overwhelming, felt there were barriers to choosing healthy meals over convenience foods and were afraid to try new ingredients. A plan was then formulated to support this person build confidence in the kitchen. That person said, “I feel more confident cooking meals now, I’ve been making changes to my diet because I don’t want to have diabetes.” This person had since lost a significant amount of weight, and this had a major positive impact on what outcome goals they could now work towards.

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

The management team and staff understood the importance of consent and had received appropriate training to understand the Mental Capacity Act 2005 (MCA). Care plans contained capacity assessments and where needed, for people assessed as not having capacity, decisions relating to aspects of their care were made in people’s best interests.

Staff demonstrated a good understanding of the MCA and its principles, including supporting people who made unwise decisions at times. Capacity was always assumed, and people were encouraged to make their own decisions. One staff member told us, “It’s not just about supporting people to make decisions, it is also giving them time and space to do so. If someone is having a bad morning, this wouldn’t always be the best time to get them to make a decision. It’s about reading their body language and coming back later if it’s going to be better for them."