Voyage (DCA) London East

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 67 (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 received effective care and support based on thorough assessments of their health, wellbeing and communication needs. Assessments were completed before people joined the service to ensure their needs could be met, including consideration of protected characteristics and cultural needs. Information from these assessments was used to plan person-centred care in partnership with people, their families and professionals.

Multidisciplinary input supported effective assessment and care planning. Health assessments enabled staff to monitor people’s wellbeing and provide timely interventions, while daily living assessments promoted independence and safety. Functional assessments informed positive behaviour support (PBS) plans, which set out strategies for supporting people, including when additional input from behaviour specialists was needed.

The provider did not always ensure care and treatment was planned and delivered in line with what was important to people. We received mixed feedback about how well people’s care reflected their needs and preferences. Some concerns were raised about people’s routines, activity needs, support strategies, and communication or sensory needs. Feedback informed us these were not always being followed in line with people’s preferences or professional guidance and had the potential to impact people’s experiences and outcomes. The provider was working with people, their representatives and professionals to address these issues.

Other feedback informed us people’s lives were enhanced by the care and support they received. Comments included, “[name] is really growing and flourishing. Their life has improved, and they are able to participate in so much more with very little behaviour related episodes.” A relative told us the service was good at understanding what their loved one liked and ‘ensuring that as far as possible these wishes are fulfilled’.

The provider worked well across teams and services to support people. Staff sought advice from appropriate professionals and made referrals for specialist input when needed. Care records showed evidence of this, and people told us about the different professionals involved in their care. For example, 1 person described the specialist support they received to help manage a health condition.

Information about people was shared effectively. Changes to care and treatment plans were communicated through handovers, team meetings and care records. Staffing rotas were planned flexibly to meet people’s needs and provide continuity of care.

The provider did not always ensure people received effective support to manage their health and wellbeing. We received mixed feedback about how well people’s health needs were met. Some relatives raised concerns about the impact of diet on physical health and wellbeing, including advice about allergies, food intolerances and cholesterol not always being followed. We sought and received assurances from the provider that these concerns were being addressed. Other feedback was positive. Relatives told us people’s nutritional needs were met well, with diets reflecting foods and tastes important to them.

People and their representatives had regular opportunities to discuss changes in their health and care with professionals and were fully involved in decisions. One person told us about attending hospital for their health condition and confidently explained how to use the specialist equipment they needed to remain well. Another person had recently attended a pain management clinic and staff were following the guidance provided to support them with managing pain.

The provider routinely monitored people’s care and support to improve outcomes and experiences. Effective systems were in place to monitor, assess and adjust support where needed. For example, 1 person’s community support was safely reduced from 2 staff to 1 after positive behaviour support (PBS) strategies helped them manage difficult situations more independently.

People and their representatives were involved in reviews. Keyworker meetings and care reviews were tailored to people’s abilities and wishes, ensuring their views were heard. People gave positive examples of their care. One person who enjoyed cars told us “I went to Mercedes World in London. It was great with lots of fast cars.” Another person said they had purchased a double bed to make sleeping more comfortable.

People were lawfully deprived of their liberty where this was necessary to keep them safe. Staff upheld people’s rights under the Mental Capacity Act 2005 (MCA). They worked with people, families and professionals to ensure decisions reflected people’s wishes and feelings. Staff demonstrated knowledge of the MCA and ensured any restrictions were proportionate to the level of risk. There was evidence of the provider regularly chasing the local authority for outstanding Court of Protection authorisations to re-new Deprivation of Liberty Safeguards.

People who lacked capacity to consent to their care had best interests’ decisions made appropriately on their behalf. Care plans contained decision-specific capacity assessments and evidence of best interests’ decision-making in line with legal requirements. This included where medicines were being administered covertly. We observed people being supported using the least restrictive options and treated with dignity and respect.