Exmoor Drive

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 71 (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. People’s care plans included detailed information about, ‘Who is [person]’, what a good day and bad day looks like for the person, communication, personal care support needs, physical and psychological health and wellbeing, mobility, eating and drinking, personal relationships and hobbies, interests and daily living skills. When we asked people if staff talk to them about their care needs and if they had seen their care plan, they said they had not seen their care plan. However, people did say, they were happy with the way they were supported. Relatives spoken with said they were involved. One relative said, “They send me a copy when it’s reviewed.” Another relative told us, “Had a meeting with the manager a month ago.”

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 a varied diet. Where people were at risk of weight loss, their nutrition and hydration was monitored. For example, for one person they required a diet low in cholesterol but high in calcium. Where appropriate people had their needs assessed by speech and language therapists (SALT) and received meals in line with recommendations made by these professionals. For example, as advised, staff supported one person with their food and drink via a spoon and at a rate of one teaspoon at a time allowing a few seconds before giving another spoonful. Staff followed the International Dysphagia Diet Standardisation Initiative (IDDSI), as guided to from health care professionals to ensure people can safely and effectively eat and drink. IDDSI is the classification system used to describe food and drink textures. We did not receive any concerns about the food on offer. One person said, “The food is good”. A relative said, “Food is fine, it’s varied more so than when at home. They puree the food for them.” Another relative said, “It made me feel hungry when I called at mealtimes.”

Staff made appropriate referrals, for example, we saw referrals had been made to the community learning disability services for behaviour support and bowel management. People had hospital passports in place to take with them if they needed to go into hospital. These detailed important information hospital staff would need to know about the person, such as, other services and professionals involved with them, known allergies, medical interventions, current medication and medical history, what to do if the person is anxious, how the person communicates and their likes and dislikes. One person said, “Staff take the passport and medication chart with us if I need to go to hospital.” Improvements could be further made with working with external teams and services to support people. One healthcare professional told us throughout their time working with Exmoor Drive staff they have had positive and negative experiences in staff ability to follow guidance set out by their team. They told us, “Liaison with staff can be difficult as it can feel like there is a disconnect between the managers and the workers such as, following an assessment. I feedback. Still when I return on occasion, I have found staff unaware of advice I have given. It appears staff may struggle to prioritise communication advice and strategies given and struggle to implement them consistently to the patient's (supported person) advantage,” However, they also said, “Following incidents our team has created and added resources to our library which benefit Exmoor Drive. Exmoor staff put these resources into place and follow them consistently. Staff on the ground are eager to learn, happy to listen to feedback/advice from us and appear to truly care for the patients they support.” Another healthcare professional told us, “I feel I have developed a positive relationship with staff, and the manager is approachable if I need to raise any concerns.”

Staff 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. Records included specialist advice and guidance for staff to follow such as, from the speech and language therapist or community learning disability nurses. People and their relatives told us they had access to health care professionals if they needed them. One person said, “The doctors come here once a week, but if bad they (staff) will call 111. Sometimes they (staff) take me to the doctor.” A relative said, “The doctor visits weekly. The optician goes in and there is nail care.” Another relative told us, “The doctor calls but only sees [person’s name] if there is a need. [Person’s name] used to wear glasses which they needed for reading and I have asked about an eye test. Tooth problem has been sorted.”

Staff 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. Staff monitored people’s wellbeing during their shifts and would report any concerns to the senior on duty. Resident of the day meetings included asking the person how they were feeling. This helped staff to identify any decline in a person’s health. For people who were unable to tell staff verbally if they were unwell or how they were feeling staff said they learn how the people communicate and can recognise their body language or change in behaviour to express if they were unwell or unhappy. One relative said, “[Person’s name] is receiving the best possible attention. They (staff) are very observant of their health.”

Staff told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood the importance of gaining people’s consent before carrying out any activity or task. People we spoke with confirmed staff ask their permission before giving care and support. People were supported to make choices and have control over their lives. Staff worked in the least restrictive way and acted in people’s best interests. They understood the principles of the Mental Capacity Act 2005 (MCA), which provides a legal framework for decisions made on behalf of people who may lack capacity. Staff had received training in MCA and policies followed MCA principles. Where people were not able to make decisions themselves, best interest decisions were in place and made with input from relatives and relevant health care professionals involved in their care. For example, people’s ability to consent to having their medicines covertly, changing bedroom, and use of equipment such as sensor monitors, had been assessed and documented.