Yourlife (Dover)

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 registered manager made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The registered manager completed robust assessments of people’s needs before they were offered a service. These were completed with the person and others the person chose to be involved. Before our assessment they told us, “Under that assessment we capture all of their needs which will include, life history, mobility issues, health problems, personal details, dietary requirements, interests, hobbies and cultural and spiritual preferences”. Assessments seen reflected this. Staff told us they always had information about the person, their needs and how they liked their support provided before they provided care to them.

Staffing levels were also considered before someone was offered a service to ensure there were enough staff, with the correct skills, to provide the support people wanted.

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. Recognised assessment tools were in place, and the registered manager knew when these were to be used. They explained how they would use Waterlow assessments to assess people’s risk of developing pressure damage. However, people using the service at the time of our assessment were independently mobile and the assessments were not required at that time. Staff kept people’s needs under review and tools were used when people’s needs changed.

The registered manager 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. Staff were paid to attend handover meetings at the beginning and end of each shift. These were recorded and staff were required to catch up on past handovers when they returned to work. Any additional support or changes in need were also recorded in the handover records, so people always received a consistent service. The registered manager attached any new or amended policies to the records, so staff were quickly aware of any changes the provider had made.

The registered manager 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 knew people well and quickly identified changes in their health; they encouraged people to contact their GP when changes were identified. A person told us staff had noted a change in their skin health and supported them to tell the community nurse. This had led to a change in their treatment. The registered manager told us, “Staff are good at spotting changes and letting a manager know.”

When people wanted, staff supported them to attend health care appointments. This was to support people to explain their history and symptoms. The registered manager told us, “This emotional support proves invaluable and has helped people recall and process any information discussed.” Staff encouraged people to follow health care advice on their return home. A person told us staff arranged transport to hospital appointments for them and chased it up if it did not arrive. This reassured people they would be on time for their appointments.

The registered manager 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. One person told us their care had increased following an accident. They told us staff had supported them to recover and regain their independence. They had reviewed their care with the registered manager and agreed to reduce their support to the level it was at before the accident. The person told us they felt in control of the care, and it had been flexible to their changing needs.

Systems were in operation to regularly review people’s care plans to ensure they continued to reflect people’s needs and preferences. The registered manager told us, “The team are extremely good at noticing when people need extra support as they know them well”.

The registered manager told people about their rights around consent and respected these when delivering person-centred care and treatment. Everyone using the service had capacity to make decisions about all areas of their life. The registered manager understood the requirements of the Mental Capacity Act, including when people could delegate responsibility for decision making to others they trusted. Staff empowered people to make decisions for themselves, including the care they wanted and when. Staff described to us how they supported people to make decisions such as telling them what the weather was like when people were choosing their clothes for the day.

A person told us they had made an advanced decision with health care professionals not to be resuscitated. They told us staff had noted the document had not been correctly signed and with the person’s agreement, had arranged for this to be addressed. The person was pleased that the correct document was now in place to ensure their wishes were followed if they were unable to share their decision with others.