You First Support Services CIC

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 a previous inspection 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 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team made sure people’s care was effective by assessing and reviewing their health, care, wellbeing and communication needs with them before the service started.

The provider ensured staff could deliver person‑centred support in line with Right Support, Right Care, Right Culture. People’s care reflected their individual needs, goals and preferences, and staff understood how to support people safely and consistently.

People had detailed, personalised care plans which set out their physical, emotional and communication needs. Relatives told us they had been involved from the start and that plans were updated as people’s needs changed. One relative said, “[Name] has a care plan, we were involved in the beginning. It has evolved over time and [name] is involved in it.”

Health and social care professionals told us the service understood people’s needs well and used detailed assessments to plan care. One professional described a person’s care plan as “Probably one of the best care plans I've seen in a learning disability service. It is person centred and really gets to the heart of who [name] is and how she should be supported."

The provider delivered effective, evidence‑based care which took account of national guidance and best practice, particularly for people with a learning disability and autistic people. Staff worked with professionals to follow agreed care plans, and people experienced positive outcomes as a result.

People with complex needs benefited from structured approaches to care supported by external professionals. Staff applied professional advice in practice. For example, speech and language therapists had supported 1 person to use new communication tools. Staff had also supported this person to learn how to use these consistently. These tools had helped the person to better understand their routine and choices. Another professional highlighted how 1 registered manager was “Very good at reaching out if she needs to discuss anything or wants advice” and described the relationship with the service as “open” and collaborative.

The management team made sure staff and teams worked with each other and with external professionals to deliver coordinated care. Staff described strong partnership working with health and social care colleagues, ensuring people’s needs were met in a joined‑up way.

People benefited from consistent staff who knew them well and from the partnership between the service, families and professionals. Relatives told us staff were consistent and understood the people they supported. One person said, “I like the staff, they are the best I’ve had. They are friendly and I know them well.”

Staff knew who to contact when people needed urgent help or when they needed to report a concern. Staff worked closely with other care professionals to ensure people received safe and effective care, and that good practice guidelines were followed.

External professionals described strong, collaborative working. One told us, “Lots of professionals” had been brought together to support a person and that joint working had led to meaningful improvements in how the person communicated and engaged in activities. They said 1 registered manager exchanged emails with them “on an almost daily basis” and reached out quickly for advice when needed.

Consistent communication between management, staff and families had been an issue and was being improved upon. Despite communication challenges, staff worked collaboratively with one another and with relatives and professionals to ensure people received coordinated, safe care. One relative said they now had “A good relationship with them [new managers] and they listen” and that concerns were responded to quickly.

The management team 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 encouraged people to live healthier lives by promoting choice, healthy lifestyles and access to healthcare. Staff understood people’s health needs and worked with them, their families and professionals to improve people’s health, wellbeing and independence.

People were encouraged to make choices about food and drink in ways that promoted their health. One person told us, “I choose my meals. I go to shops and buy it, staff cook it.” A relative described how staff supported another person who needed encouragement to eat healthily. They said, “A meal planner is done weekly and now he eats more fresh vegetables and fruit.”

People were supported to be physically active and to take part in activities they enjoyed. Relatives told us staff encouraged independence with going out, going to the gym, to the shops, for meals out, to the cinema, and trying new things at a pace that suited each person. A relative told us their family member, “This year, he is getting out more. He went on holiday with a carer and had a lovely time."

The provider consistently monitored and improved people’s outcomes. Managers and staff used reviews, incidents, feedback and professional input to identify learning, make changes and improve care and support.

Staff support had led to many improved outcomes for people. A professional told us, “[Name] has a small and dedicated staff team who have done some amazing work. [This person had] “Come a long way” since being supported by You First. They described how the person was now clean, well dressed, more settled and showed clear signs of “How happy, relaxed and content they were.” Staff had introduced new activities gradually, such as baking. The professional said this person, “Would never have baked or eaten with staff a year ago.”

One person had been supported to complete ‘train the trainer’ training and now regularly visits care homes to help train care staff, which improved their confidence, wellbeing and sense of purpose. Their relative said, “The carers do a fantastic job, they are excellent. When [name] decided to do the training [in providing safe, compassionate, and informed care to autistic people and people with a learning disability], staff supported her and now [name] goes to care homes twice a month to train and help other people.”

One staff member described the work You First did with one local organisation. They said, “One lady has flourished. We made reasonable adjustments to support her learning [which were successful].” They were now in paid employment. This staff member was also acting as a ‘job coach’ for people, exploring job opportunities and preparing people for interviews.

People’s care plans were kept under regular review and updated as needs, goals or risks changed. Relatives said when concerns were raised, managers listened and acted on them. The service had a “no blame culture”, with all accidents and incidents used as learning opportunities. For example, after 1 serious incident, management responded immediately to support both the person and the staff involved. Managers went to the person’s home, offered staff support, ‘time out’ and used the incident to review and strengthen care practice.

Managers used structured quality assurance processes, such as audits, action plans and regular manager’s meetings, to monitor performance and drive improvement across the organisation, including for people in supported living environments.

The management team made sure people were supported to have maximum choice and control over their lives. Staff knew people well, respected their wishes and worked with them and those important to them to agree care and support in line with people’s rights.

People made their own choices and decisions; family members were involved when decisions were made in people’s best interests. People told us they made everyday choices about what they ate, wore and did. One person said, “They [staff] do ask me and give me choices.” A relative said, “[Name] is in control. She is asked what she wants to wear, how her hair is done and what she wants to do.” A staff member told us, “[Name] has all of their needs and choices met. We [staff] listen to them and allow them to process information in their own time.”

Relatives said staff and managers involved them in decision making, where appropriate, and in planning and reviewing care. One relative told us, “We have had conversations with managers when we felt [name] needed something different, we are all on the same page.” Another said they had access to their family member’s care plan and were listened to when they suggested changes.

People and relatives told us they felt able to speak up and that managers and staff listened. One relative said about their family member, “They [staff and managers] see her and hear her."