First Thought Care Services

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 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.

People’s care provision started after a comprehensively planned and holistic assessment of their needs, preferences, and aspirations to ensure staff fully understood people’s care needs.

Staff were introduced and informed of people’s support requirements. They worked with people, families, health and social care professionals and care providers already involved in their support to ensure staff could effectively support them and understood their needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. The provider worked with staff, professionals and people to develop and deliver evidence-based good practice and standards.

Systems were in place to review all incidents to ensure people had been supported using the principles of PBS and to ensure all interventions were underpinned by the Restraint Reduction Network practices to reduce restrictive practices. Detailed assessments were in place to guide staff on people’s choices and preferences around their nutrition, hydration and activities. Risk management and positive behaviour support plans were in place to guide staff on people’s support requirements in line with guidance. The provider was aware of the importance of delivering a person-centred approach with the aim to reduce incidents and the reduction of people’s medicines as required by STOMP.

The provider mainly worked well across teams and services to support people.

There was a strong focus on working collectively as a team in the best interest of people. Effective systems were used for information sharing and communication across the staff team, including team meetings and internal messages. Concerns were quickly escalated internally, and advice was sought from internal specialists and positive behaviour support practitioners as needed. Staff told us they fully involved in sharing information and giving updates on people’s care and their outcomes. The provider had developed an internal staffing structure which had improved the oversight and communication around people’s care.

However, whilst staff felt communication was good across all levels of the service; relatives expressed mixed views regarding the communication about their family member. Some relatives said the communication was good; however, one relative shared they were not always informed family member’s well-being and activities after staff visits and outings and felt this could improve. They said, “We used to get photos of [person] but not for some time now.”

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.

Staff supported people to live and maintain healthier lives such as eating healthy meals and maintaining good hydration while carrying out activities. We were told staff would be made available to help people to attend health appointments or support relatives as needed. Pictures and other forms of communication tools and strategies were used to support people to understand healthy living and overcome any barriers or fears.

Relatives told us staff understood people’s health needs and escalated any concerns about people’s health to them. Staff said they were aware of people’s individual health conditions and had the information they needed in peoples care plans to guide them on how to support people.

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.

The provider had systems in place to monitor the care provided to people and regularly met with relatives. Staff recorded the support they provided and people’s well-being which were monitored by senior staff and team leaders. The service focused on continually assessing people’s needs and wishes with the aim to consistently improve people’s quality of life. Relatives mainly felt people’s health and wellbeing had improved over time since 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 were involved in day-to-day decisions about their care. Relatives told us staff provided people with choice and provided care in their best interest. The provider worked closely with people’s families especially when they were transferring into the service. The provider explained they worked sensitively with relatives to help them understand the importance of positive risk taking and respecting people’s choices and wishes and accepting people’s decisions.

Staff and managers had been trained in understanding consent and making best interest decisions in line with the Mental Capacity Act 2005. Although we found no impact on people, we noted the provider’s assessment and rationale for specific restrictions and decisions were not systematically recorded for all people. The provider agreed to review their assessment processes to ensure there was a consistent approach in assessing people’s mental capacity.