Advance Essex and East London

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

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The Head of Operations told us people were fully assessed before they started using the service and this was regularly reviewed with people and their relatives. A person-centred care package was then put in place and regularly reviewed. Staff had access to information on people’s care, on the care planning application they used on their device and a printed copy was also kept in peoples’ home. A member of staff told us, “We get regular updates from the manager if any changes have been made to peoples care plans.”

The service 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. Staff knew people well and how they wished to be supported with food and drink. Assessments were in place to help staff recognise the support people required, and where required, staff had undergone additional training to recognise if people were choking and how they could intervene. However, not all information in a person’s care plans was up to date. Following the assessment, the support manager ensured people’s care records were updated and contained accurate information.

Where required the service liaised with health professionals to ensure people were receiving the correct support with their food and nutrition.

The service 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 had access to the information they needed to work with people, and where required helped them safely transition between healthcare teams. The Head of Operations told us they had developed good links with other health professionals. Where appropriate, staff supported people to attend health appointments.

Staff meetings and supervision sessions were all in place to ensure staff were provided with current information to work together to support people.

The service 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 need for care and support. A member of staff told us, “I familiarise myself with a person’s care plan and get to know the person before supporting them. I want to make sure they can live their best life.”

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both people’s and clinical expectations. The Head of Operations told us they had several systems in place to help them monitor outcomes for people. This included asking people for their feedback through the completion of surveys on their care experience. Survey results were analysed for any themes and trends and discussed during management meetings. However, the survey’s sent out were anonymous and the Head of Operations told us it was difficult to identify what service the feedback was applicable to. Following the assessment, the Head of Operations told us they were changing the format of the surveys . The support manager told us they speak to people regularly to obtain feedback. However, there was no formal record of these discussions.

Consent to care and treatment was sought in line with legislation and guidance. People we spoke with told us they were able to make some informed choices.

Staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff understood the need to gain consent from people to support them with their care needs and in making decisions. Staff told us, “I have recently completed my training, and I understand the importance of gaining consent from the people I support.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty.

We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

We found staff practice reflected the principles of the MCA. People were encouraged to make their own decisions, while still minimising risk. Staff understood their roles and responsibilities in relation to the MCA 2005 framework.