Stepping Stones to Independence

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 relatives told us they had been involved in the care planning process and reviews. People were encouraged to engage in reviews where possible. One person explained, “I have a care plan that is in a blue folder that they leave with me. Sometime this year I had a review.”

People and relatives told us they felt staff understood and met their needs. Staff confirmed they usually knew people well and felt this helped them provide more tailored support.

Care plans showed that a wide range of needs had been assessed, included physical, health, wellbeing and communication needs. Staff told us they had access to care plans and were encouraged to read these. One staff member said care plans were not always fully up to date or reviewed when there were changes in people’s needs, although another told us, “There is a good plan in place, and I follow the instructions available in the care plan.” The registered manager was reviewing all records and care plans following this inspection to ensure they were accurate and continued to describe people’s current needs.

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 registered manager participated in forums and networks to ensure the service was up to date and delivered support in line with current guidance.

Care plans included person-centred information about people’s nutrition and hydration needs when staff provided support in these areas. People were given choices about food and drinks and their preferences were known. One person said, “Sometimes they were doing the same food all of the time. Now they have put a chart up to say different food needs to be done.”

Staff received training in specific subjects such as learning disabilities and the management of diabetes. This ensured they used up to date approaches to deliver the support people needed in line with best practice.

The provider worked well across services to support people, although staff felt this was less effective within the organisation. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People or their relatives believed different agencies shared information appropriately to provide joined up care. However, they also told us there had frequently been changes of staff at short notice. This affected continuity or consistency in approach for some people. When we asked one person about this, they told us, “They change the staff. The staff are all different. I don’t like different.”

Staff told us they communicated and co-ordinated well with external professionals to deliver high quality support. However, several felt communication was not always effective within the organisation. Comments from staff included, “Communication could be better about rota changes” and “I feel that communication could be improved a lot.” The registered manager had recently arranged for a staff member to become a communication champion and they were recruiting a new co-ordinator to help improve communication and consistency.

Feedback from professionals was very positive regarding working in partnership with Stepping Stones to Independence. One professional told us they were updated regularly when the service had faced staffing challenges, and another professional added, “The management team work really proactively with me. They attend all the multi-agency meetings, risk management meetings and regular review meetings and contribute very effectively and helpfully during these.”

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 manage their own health needs where possible and assisted other individuals to attend appointments or carry out tasks to stay healthy. People were encouraged to make healthy choices and be physically active in line with their needs and preferences.

Care plans contained personalised information about people’s medical conditions and health needs. This included specific guidance for staff about how to manage or reduce associated risks. Staff told us they usually knew people well, and so they noticed if someone’s health or wellbeing was deteriorating. We saw evidence that professionals had been contacted in a timely manner when people’s needs had changed.

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.

Staff were passionate about ensuring people could work towards and achieve goals which were meaningful for the individual. Staff supported people to have a good quality of life and achieve positive outcomes. For example, people told us they enjoyed doing arts and crafts and going shopping and appreciated the support staff gave them with these activities. A relative explained how staff supported their family member to maintain a job, and another told us about the different physical activities staff attended with their relative.

Care records evidenced how people had been supported to improve their independence and quality of life. Aims and goals were reviewed and adjusted as people’s needs and strengths changed and outcomes were achieved.

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 their views and wishes were considered, and staff sought their consent before supporting them. One person said, “They always do as I ask them to do. They treat me with respect. No problem there.”

The registered manager described ways in which people were given extra support to help them make informed choices. For example, by providing large print or easy to read information, or giving additional time to ensure understanding.

Staff received training in the principles of the Mental Capacity Act and put this into practice when they supported people. For example, by respecting people’s wishes and preferences, treating people with dignity and giving them meaningful choices. At the time of our inspection, no-one was subject to restrictions under the principles of the Mental Capacity Act 2005.