Office G19

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• 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. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Peoples’ needs, and choices, were assessed and took account of preferences for their support. Protected characteristics and diverse needs under the Equality Act formed part of this process. For example, people’s religious needs and preferences were captured.

People confirmed that they, and their relatives, were involved in their assessments of needs and reviews of their care. We saw evidence that care plans and risk assessments were continuously reviewed and updated when people’s needs changed.

People receive care, treatment and support that is evidence-based and in line with good practice standards. The provider’s systems ensure that staff are up to date with national legislation, evidence-based good practice and required standards.

Each person had a full assessment of need in place, assessments which were supported by use of best practice tools and required standards. For example, positive behaviour support plans were in place to support people. These are person centred frameworks for providing long term support to people with a learning disability, and/or autism, including those with mental health conditions, who have, or may be at risk of developing, behaviours that challenge.

The service worked well across teams and services to support people. When people received care from a range of different staff, teams or services, it was co-ordinated effectively. Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. One staff member said, “All team members treat each other with respect and work together in team spirit which is one of the things I appreciate.”

Professionals and partners in care said that the management and staff were effective in information sharing and partnership working. Appropriate and timely referrals were made when needed. One professional said, “They communicate any changes following secondary care appointments for the residents well. They liaise closely with our nursing team. After any patient appointment they request written feedback for their own documentation to ensure any advice and changes are correctly made.” One staff member said, “We also work in collaboration with external professionals like GPs in order to have as much information as possible about the people we support.”

People were supported to manage their own health, care and wellbeing needs by staff who understood their needs and preferences.

People required full support to effectively manage their ongoing health. Staff arranged medical appointments while making referrals to specialist services when additional health support was identified as being needed. One professional said, “I have been impressed with the management team and staff. They raise concerns with us about any health issues for their residents promptly. They support the residents to attend appointments, both for the regular screening and learning disability assessments, and for appointments to manage acute medical issues.”

Staff identified when guidance and management of specific health needs was required. For example, detailed assessments were completed to help people manage safe and healthy relationships while sensitive guidance was in place to support with understanding of menstruation.

Oral health assessments had been completed for some people to ensure that they could be supported to maintain good oral health. Appropriate referrals had been made to specialist services when additional health support was identified as being needed. One professional said, “I have known service users before and after they moved to the Chalet and can see an improvement in their health and care."

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

Quality Assurance systems were in place to monitor people’s outcomes and support. Care plans, risk assessments were consistently reviewed and updated to reflect people’s changing needs and to ensure that safe and effective support continued. Training, effective communication and information sharing to and between staff meant they were clear on the standard of care expected from the provider. One staff member said, “All tenants we support have up to date and detailed information about their support needs, likes, dislikes, allergies, medical history, support plans and risk assessment on (care management system).”

People’s views and wishes were taken into account when their care was planned.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Some people lacked the capacity to make certain decisions, and the provider ensured they gained informed consentfrom people authorised to consent on their behalf, for their care and treatment.

Staff received training on the Mental Capacity Act and understood their responsibilities regarding MCA. One staff member said, “Staff recognise that tenants have varying levels of mental capacity; if the tenant lacks capacity, we apply the Mental Capacity Act 2005, the next of kin is consulted to arrive at decision that are in the best interest of the tenant. We empower them with choices, and this help them to make decisions in their best interest. We strictly follow the principle of person-centred planning and care.”