Believe Care and Support Ltd

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 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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were comprehensively assessed ahead of the provider accepting their package of care. The provider also ensured that people moved into their care in a staged approach which allowed people to build a relationship with staff before fully transitioning into the service; working with people, their families and relevant professionals to ensure people were best supported with the transition.

Multiple professionals who worked with the provider to place packages of care told us the provider had made significant improvements to people’s care by thoroughly assessing needs and working tirelessly to achieve the best possible outcomes for people. One professional told us, “Due to my experience with Believe I have suggested they be approached for other complex cases by my team. We have had very mixed experiences with 3rd parties however up to now everything has been positive with Believe.” Another professional told us, “I have no issues or concerns with this care provider, and I wish more care providers could work with the same high standards of care they provide with the person at the centre of all they do and provide.”

Professionals praised the providers dedication to attending all multi-disciplinary meetings for people.

Assessments explored people’s personal experiences and life histories through a range methods such as the use of picture boards and electronic information devices. This holistic approach allowed rich and detailed information to be captured. Care plans contained robust and practical guidance on the most effective way in which to communicate with people, supporting staff to deliver care that was respectful of people’s choices and responsive to their needs. People’s care and treatment was regularly reviewed to ensure that people’s needs continued to be met, and that measures in place to support people remained effective.
 

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 registered and deputy manager kept themselves up to date with changes to guidance, sharing them across the staff team to ensure people’s care and treatment was delivered in line with current best practice. We saw one person’s outcomes had been significantly improved because of excellent management of their behaviours that communicated distress. As a result, their need for some prescribed medications had been removed and others reduced. This also evidenced the provider’s understanding and promotion of STOMP.

Prior to being supported by the service, one person had more than 13 care placements fail, and had spent numerous years as a hospital inpatient due to these inappropriate care placements. Since transitioning into the service, the person has been well supported and had not had any re-occurrences of hospital in stays.

The provider also demonstrated success with managing people’s health conditions to the point where people were supported to return to increased levels of physical activity, which helped to support them achieve a healthier weight following a period of unwanted weight gain.
 

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.

Although we received some mixed feedback from staff around the theme of communication and listening, most staff that we spoke to praised the providers approach to collaborative working, telling us that they felt listened to, and that feedback given was valued by the provider and acted upon. The provider’s effective systems of governance and oversight had identified where improvements in communication needed to be made and had responded appropriately. Information was shared with team leaders who in turn shared this information across their team during daily handovers or team meetings. Each person’s team leader had a nominated individual within the management team to liaise with. This supported clear lines of communication and delegation of responsibilities. Feedback from professionals was overwhelmingly positive, highlighting the providers attendance and active engagement at all people’s multi-disciplinary team meetings.

People had their own individualised hospital passports in place. These contained detailed and up to date information about people’s communication, mobility, dietary, positive behavioural support strategies and religious and spiritual needs, as well as their likes and dislikes. These passports enabled other healthcare professionals to effectively support people when they transitioned between services.
 

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.

Although not registered to provide nursing care, the provider employed their own nurse, who delivered training in health specific conditions such as epilepsy and diabetes to staff. People received annual learning disability, and medications reviews. People were also supported to attend regular dental, opticians and chiropody appointments.

The provider also demonstrated that they made appropriate and timely referrals to other relevant health professionals when needed and followed their advice accordingly.
 

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

The provider, management staff and people’s staff teams held annual planning days with people to set goals for the year ahead. Progress in attaining these goals and achieving desired outcomes was monitored by way of electronically monitored progress charts which were regularly reviewed by the provider. We saw how one person had been supported to record a song at a local recording studio, working with the sound technician to find the right musical accompaniment to their chosen track. Achieving this outcome resulted in increased confidence for the person, who had then gone on to write and perform their own song in front of staff and others at a Christmas party.

People had health action plans in place, and these demonstrated how people’s outcomes had improved. The provider was member of the Restraint Reduction Network and was able to evidence a significant reduction in the use of physical and chemical restraint for people, instead utilising effective positive behavioural support plans to manage peoples distressed behaviours. One person relative told us, “His behaviours are so much better now, they (staff) don’t have to restrain him half as much as his old (care) company did. He’s still not the easiest person, but his staff do a brilliant job with him now.”
 

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

Staff told people about their rights around consent, and information was available to people in a way they understood, such as easy read documents. We observed staff seeking consent before supporting people and being guided by people’s responses. We observed people being encouraged to exercise their right to choice and saw evidence of the provider supporting people to seek their goals, despite discouragement from others.

When making decisions around people’s capacity the provider followed the 5 core principles of the Mental Capacity Act 2005. Staff involved relevant professionals and those important to people to ensure people’s human and legal rights were respected. When people were assessed as lacking the capacity to consent to decisions around their care and support, decisions were made in their best interest, and the least restrictive options were considered and recorded. These decisions were regularly reviewed to ensure their appropriateness.