Foundation House

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 Outstanding. At this assessment the rating has changed to 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 were involved in the care planning process which enabled open discussions about people’s care to ensure their needs could be fully met. These assessments were then used to develop individual care plans, setting out how their assessed needs should be met.

Assessments were ongoing and reviewed regularly. The reviews included input from people’s families if they chose, other professionals and any external stakeholders so a multidisciplinary approach was taken to meet all aspects of a person’s care needs. Staff confirmed information in the care plans was updated in line with any medical test results if a dietician was involved or if the person requested a change.

Although partnership working was generally effective, leaders described ongoing challenges in obtaining timely responses from some local authority professionals when arranging statutory reviews. The provider had a process to help manage these delays and ensure reviews continued where appropriate, so people were not disadvantaged by these delays.

People accessing the service used a wheelchair and required varying levels of support and equipment for transfers. Staff demonstrated a good understanding of people’s mobility needs and how they needed to be supported to navigate their environment as independently as possible.

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.

People’s health needs were regularly monitored and reviewed, and staff sought specialist advice when required, particularly for people with complex health conditions. The service worked in partnership with external healthcare professionals, including GPs and specialist services, to ensure people received appropriate and timely support. People’s care was informed by specialist assessments and clinical guidance.

If people needed support with nutrition and hydration, this was recorded in their care plan. Staff ensured people had access to snacks and drinks within reach before they left people’s homes. One person told us staff were mindful to ensure they were at the forefront of their care delivery.

The provider 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.

The provider worked collaboratively with staff, health professionals and partner organisations to help ensure people received coordinated care and support. Effective communication between teams supported people to access healthcare, maintain their wellbeing and achieve positive outcomes.

Staff worked closely with a range of multidisciplinary professionals including community learning disability teams, mental health services, physiotherapists, occupational therapists, speech and language therapists, nursing staff and dietitians. This helped ensure people received specialist support when needed and care could be adapted in response to changing needs.

There were clear arrangements for sharing information across teams. Details of professional visits were clearly recorded in people’s care records.

The service maintained positive working relationships with external healthcare professionals. Feedback from a healthcare professional was positive and confirmed staff responded promptly when appointments needed to be rearranged and communicated effectively regarding people’s ongoing support needs.

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.

People had access to healthcare professionals and specialist support when needed. Care plans contained detailed guidance for staff on managing complex health needs, including respiratory care, skin integrity, oral health and specialist nursing interventions. Staff knew when concerns needed escalation and described working with nurses, GPs and other healthcare professionals to ensure people received appropriate treatment. One staff member said, “When taking care of residents if you discover a sore on the person, you report to the nurses, responsibility of the nurses to check the sore and ask about it. Contact the GP if needed”.

The service promoted healthy lifestyles while respecting people’s rights to make their own decisions. Staff encouraged healthier food choices and supported meal preparation where required.

Staff monitored people’s wellbeing and were responsive when health concerns arose. Records showed interventions were reviewed and adjusted in response to changes in people’s health. People were involved in regularly reviewing their health and wellbeing needs where appropriate and necessary.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

Systems were in place to monitor outcomes and respond to changes in people’s health. Care plans set out people’s needs, and staff worked collaboratively with healthcare professionals to review risks, monitor progress and support people to achieve positive outcomes. Health professionals we spoke with gave positive feedback about staff and working with the service.

People’s support was delivered consistently by staff, in a person-centred way, specific to their needs. Staff demonstrated an understanding of how to monitor changes in people’s health. They described observing people's behaviour, recognising signs and symptoms of ill health, and reporting concerns to nursing staff so appropriate action could be taken. One staff member told us, “I monitor people's health by being aware of new changes in their routine and how they feel, noting signs and symptoms, facial expressions, assessing, acting on other staffs reports and actual verbal complaints of not feeling well and taking observations.”

The provider also invested in workforce development to improve outcomes for people. Bespoke training delivered by leaders, nurses and therapists helped staff understand individuals’ healthcare needs and the reasons behind specific interventions. This promoted a consistent approach to supporting people and embedding best practice across the staff team. One leader told us, “We did some bespoke training providing an overview of each resident and then a nurse came and spoke about people’s medical needs, and an inhouse physio therapist went through different stretches and what they were for.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s ability to consent and how they showed consent was consistently well documented, with clear records demonstrating individuals were appropriately informed and had agreed to the care and support provided. Staff understood the significance of providing a clear narrative to ensure people could give informed consent to daily choices and decisions. One staff told us, “When supporting to make a decision, we should make sure the information is simplified, broken into smaller chunks, don’t overload them [people]. Make sure it’s the right time for the person (e.g. some people might be better in the morning, others later in the day), use communication aids if it helps (e.g. pictures), different formats that suits the individual’s needs. And involve people who know them, family, friends, health professionals.”

People told us they were not confined by any impositions or undue restrictions and were able to spend their time as they chose doing things important to them. One person told us they directed staff to the support they needed and were listened to. We saw this person’s care plan stated staff were to provide clear information to support them to make their own decisions and respect the person’s rights and autonomy.

Staff spoke confidently about gaining people’s consent, demonstrating a clear understanding of working within legal requirements, organisational policies, and person-centred practice. We observed in practice staff recognised the importance of seeking consent before providing care and demonstrated considerable respect for listening to and following peoples wishes.