Three Roses

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 75 (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.

While some people told us they did not have access to their care plans, others confirmed the information was available within their homes. Leaders told us care plans were routinely left in people's homes and that people could also choose to access and review their information electronically through the provider's digital system.

Records showed people's needs were reviewed regularly and whenever there was a change in their circumstances or support requirements. Care plans contained detailed information about people's individual needs, preferences and outcomes, providing staff with clear guidance.

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.

The provider was able to demonstrate evidence-based care and treatment within their care planning documentation. People told us care was given in a way which mattered to them. Where people chose to decline aspects of their care or support, this was clearly documented, including the reasons for their decision. Staff appropriately escalated concerns to relevant health and social care professionals where refusals may have impacted on people’s health or wellbeing.

People’s food preferences, intolerances and allergies were clearly documented and people who required a modified diet were supported by staff who knew their responsibilities. One staff member commented, “Person has dysphagia and is at risk of choking, meals have been appropriate assessed, and we must monitor when they are eating, record and report if there is any coughing. If they start choking, we are trained how to respond and must call an ambulance.”

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.

People and their relatives told us the service contacted other agencies on their behalf. Staff told us contact with professionals was done through the main office and this was effective. The registered manager told us they had good working relationships with professionals in the community and knew who to refer to when needed. Professionals provided positive feedback, one comment included, “Communication with our team has always been effective.”

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.

People told us staff supported them to live healthier lives. Comments included, “The carers help me to have a little walk,” and “They help me with physio at a certain time every day.” Staff demonstrated a good understanding of how to support people to achieve their health goals and maintain their wellbeing. One comment included, “With one person, we are doing exercises to improve their mobility. We can see positive change, and they say they feel much better.”

Records demonstrated people were supported to access a range of healthcare services when required, including GPs, community nurses and other health professionals.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People told us they had been involved in the development and review of their care plans and felt able to discuss any changes to their support needs. The provider had systems in place to ensure care plans and risk assessments were reviewed and updated when people's needs changed, helping to ensure care continued to reflect their current circumstances.

Leaders maintained oversight of people's care through regular reviews and updates to care records. Staff told us they communicated any changes in people's health, wellbeing or support needs to the office, enabling care plans and risk assessments to be amended promptly where required.

Daily care records were completed using an electronic care planning system, which guided staff through tasks specific to each person's care needs during every visit. This ensured key information was recorded and provided leaders with real-time oversight of care delivery. The system enabled managers to monitor outcomes, identify any emerging concerns and take appropriate action to support outcomes for people using the service.

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

People and their relatives told us staff asked for ongoing consent when they were supporting them with their personal care needs.

Staff demonstrated a good understanding of the principles of consent and were able to explain how they supported people to make their own decisions. Staff had completed training in the Mental Capacity Act (MCA) 2005 and showed a good awareness of their responsibilities when supporting people who may have difficulties making some decisions. For example, one staff member said, “Always assume a person has capacity, it’s not us who decides. Respect whatever they decide, respect their wishes. As carers we can’t just do what we want.”