Eliot Gardens

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 service under the new provider. 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs.

The provider ensured people’s support needs were assessed appropriately. This began with a pre – admission assessment, following that further assessment tools to understand people’s physical, emotional, and social needs had been completed. People’s care records were detailed and included information on people’s communication needs.

The provider ensured people’s risks were being monitored including a person who was at risk of skin breakdown. Any concerns were reported immediately and recorded in the daily notes and on a skin inspection chart to inform leads and other professionals. Some of the assessment tools used to ensure people’s needs were being met were completed by external professionals including district nurses.

Care records and risk assessments were reviewed regularly by senior staff. We saw an example of a person’s risk assessment for nutrition and hydration being updated immediately following a choking incident.

Despite the care records and risk assessments being up-to-date, detailed and informative for staff, most people, and relatives we spoke with were not aware of them and therefore unable to state whether they were confident their individual needs had been appropriately assessed and fully understood. When we raised this with leaders, we were told they were confident people were involved in updates to their care records and were unsure they would be aware of specific terminology including ‘care plans’ or ‘care records.’ They stated they would consider how to communicate this effectively with people and relatives.

Some risks recorded within the person’s care record did not have corresponding risk assessments. When we raised this with leaders, they confirmed these risks were historic and not appropriate at present. Since the inspection, the registered manager had created a new form which documented any changes from the original care record to indicate why some risk assessments may not be relevant currently.

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 received care and support based on best practice guidance and current evidence. The provider used care planning tools to identify and monitor needs. Care records were detailed, person – centred and reflected evidence – based approaches in areas such as medication support and mobility. Staff followed guidance from external professionals including the Speech and Language Therapy (SALT) team and community physiotherapists. For example, staff knew about a person who was on a modified diet.

Staff were supported to understand how national best practice and local clinical advice informed their work via training and supervision, for example staff understood the importance of hydration and regular repositioning.

Staff ensured care records were updated promptly when changes were made.

Staff told us they had access to policies and procedures and the time to read them and people’s care records in detail.

Leaders told us they attend the ‘Skills for Care’ forums which provided them with appropriate updates. The registered managers attended monthly meetings in which updates to legislation or evidence-based practice were discussed.

Nutrition and hydration care records contained the appropriate details and outlined the support required for people. This included whether the person had any dietary needs, whether they were open to the SALT team and what support was required for them to eat.

Staff completed risk assessments in relation to nutrition and hydration. These were mostly, up to – date and outlined associated risks.

The provider always 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.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support.

Staff told us schemes worked well together. A member of staff said, “We all work well together and support each other if there are any concerns or incidents.”

Staff said they had good working relationships with external professionals. A staff member said “Generally I feel confident with all the people that I work with, but we can always get support from services such as the hospice or district nurses. We have a really good relationship with them all, especially the district nurses.”

People’s care records clearly outlined information and advice provided to the person by external services. From this, we could see the vast amount of input services had with the provider and the person being supported. The provider recorded any interactions between services well.

All partners commented on strong working relationships with the provider, especially the 2 more established schemes. A partner stated, “Eliot Gardens staff have a willingness to engage in MDT (multi – disciplinary team) working and this has greatly enhanced collaborative care planning and safeguarding processes.”

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.

The provider regularly monitored people’s health which included ensuring people’s health was being regularly monitored by health and care professionals. People’s health and care was regularly reviewed as part of their care record review. Within the care review, was a section dedicated to people’s health concerns and how staff should support them. Risk assessments clearly indicated people’s diagnoses, associated risks and controls.

The provider had policies and procedures in place which considered people’s health and wellbeing. An example of this was their smoking policy which ensured people smoked only in their apartments and not in communal areas.

The staff, in agreeance with the person, were proactive in engaging with healthcare services such as SALT, district nurses, dieticians and specialist nurses when this was required.

People were empowered to make their own decisions to manage their health. For example, the provider supported people to maintain good physical and mental wellbeing, including regular access to strength and balance classes held at certain services. People had the capacity to attend or decline the sessions as they wished.

The provider had various case studies of people being supported to live healthier lives. A person who had suffered a stroke wanted to re-engage with previous activities which they had enjoyed. The provider helped to signpost them to local services which meant they were able to participate in attending the gym and the local swimming pool. Another person had overcome a significant drug addiction and had lessened their consumption of alcohol dramatically since living in one of the schemes.

Overall partner agencies were complimentary about how the provider promoted the wellbeing and health of the people they supported including how promptly they were contacted if any concerns arose, however one partner felt staff could not always support people to appointments which meant delays in them being seen. The same partner felt staff did not always escalate their concerns early enough in the day which meant appointment availability was often limited. The registered manager told us the provider supported with appointments when an assessed need had been identified and commissioned. They also told us the level of staff planned throughout the day fluctuated due to the commissioning model meaning immediate support to appointments was restricted.

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.

There were effective approaches to monitor people’s care and treatment and their outcomes. The provider had an outcomes section in each of the care records which were held electronically. The outcome document had a list of goals and aspirations for each of the people being supported. The goals had been broken down into steps which meant incremental targets were set and often achieved. The provider ensured people’s care records and risk assessments were regularly reviewed. They were reviewed every 6 months or if a change had occurred, this ensured people’s care and treatment was regularly monitored.

People consistently experienced positive outcomes. These met agreed expectations as set out in legislation, standards, and evidence-based clinical guidance. It was evident people’s quality of life had improved, they were more independent, safe, had a continuity of care from staff and there were opportunities to improve social connections. The provider shared numerous examples of people experiencing positive outcomes. These included a person who on arrival to the scheme was unable to express themselves verbally, lacked confidence to leave their apartment and lived following orders and routines set by others. Currently, this person has improved confidence meaning they are able to access the community and now expresses their needs and wishes with their support team. Another person had heightened anxiety and had become withdrawn following the COVID-19 pandemic. Following encouragement from consistent staff members, the person was gradually exposed to outdoor activities again, which included attending the local park.

Whilst attempting to improve outcomes, staff, and leaders’ approach to this was balanced and proportionate. An example to demonstrate this was in relation to a person who had been a drug addict and an alcoholic prior to their move to one of the schemes. The person had made a vast amount of progress since they had arrived, however it was still acknowledged the person required, although a lesser amount, alcohol through the day. A target had been agreed with the person and their relative which staff monitored and encouraged the person to maintain.

People’s care and treatment continuously improved based on the providers approach to monitoring and improving outcomes. The staff, as already mentioned, had a good understanding of people’s care, treatment and overall presentations which meant any changes were voiced or documented in appropriate forums such as escalating to management, discussing in team meetings or in handovers.

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

The provider had systems and processes in place in relation to people’s consent to care and treatment. Staff had received training on the Mental Capacity Act. The provider monitored people’s capacity and made appropriate referrals to services when required.

The provider promoted people’s independence and choice in daily matters, such as when they received support, this demonstrated respect of people’s rights, autonomy, and dignity.

The provider had developed a restrictions screening tool which outlined the different restrictions in place on people in areas including “my health,” “communication” and “my personal care.” The tool functioned as a prompt sheet for staff to use to understand whether people needed support in certain areas.

People within the schemes received information about care and treatment in a way they could understand and had appropriate support to make decisions.

Staff understood the need to ask people if they required help before doing so. People corroborated this and one person said, “They always check with me first, they don’t just do things without asking me.”

People’s care records clearly documented their consent to the care and treatment being provided. The provider had consent forms in place for care and treatment, for holding medication keys and for photographs to be taken of them. However, the consent forms did not always have dates on them which meant we were unable to determine if they had been updated regularly. Additionally, a person who had not provided consent for photographs to be taken had appeared in their internal magazine, this required better oversight.