Telscombe Road

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. A thorough pre-assessment process was in place for anyone wanting to move to the service. The initial assessment of needs determined which of the five linked services would be most appropriate for people. People, their loved ones, the local authority and other significant professionals were involved in this process. People then visited for a few hours when other residents were out and then gradually increased their time at the service, meeting other people and staying overnight. A relative told us, “Pre-assessment did happen. I was involved in helping settle in. Staff went with it and the suggestions I made.” Care plans and risk assessments were reviewed monthly by the registered manager and their team with any changes in people’s care and support needs being recorded. Any short term changes in people’s presentation and mood were noted and staff were updated and the daily shift handover meetings.

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 were involved in planning and agreeing the care they received. Within one care plan there were hand written notes, signed by the person, agreeing to keeping safe in certain circumstances. For example, when out for walks or at the swimming pool. These notes helped the person remember agreed plans and responsibilities to keep safe. At the front of every care plan was a section called, ‘learner essential information sheet.’ This provided a quick overview of key information relating to people. It covered levels of understanding and subsequent levels of support needed with daily activities and routines. It described detail of the things that made people happy that would lead to a good day and things to avoid that might frustrate them or make them anxious. Relatives confirmed that people’s care and support was delivered in accordance with their needs. A relative told us how their loved one was able to move bedrooms to help them sleep better as the new room was quieter. This fitted in with the others living at the service who preferred to stay up later each evening.

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. Care plans were ‘living documents’ that were added to and updated regularly in addition to the monthly reviews. A one page summary at the beginning of the document, known as the hospital passport, summarised people’s needs and most up to date support plans. These were used to inform visiting professionals but would also go with people if they had health or social care appointments with other professionals. People were accompanied by staff who were key workers when away from the service. A small team of key workers supported each person every day and night and they knew people well and could support and advocate for them when keeping appointments. A relative confirmed the smooth movement between services when keeping appointments, one telling us, “Staff are amazing and attentive all the time. They have made a referral to community learning disability team (CLDT) and there is a parallel plan for supported living.” The daily, term time transition between the service and the college ran smoothly with staff from the service present for transfers and handovers, ensuring smooth transitions and minimising people’s anxiety when moving.

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 took it in turns each day to create a menu of food options for the day. A calendar on the wall in the kitchen showed what meals were available and who created the days menu. There were always alternatives available. People were encouraged and supported to create healthy meals, mindful of any allergies or dislikes or cultural needs that others might have. A relative confirmed with us, “They choose meals, lots of choice and alternatives provided and lots of snacks available too.” There were oral health risk assessments in place and documents confirming that people regularly were seen by a dentist. Similarly there were regular GP reviews of people’s health and everything was done to keep people healthy with regard to diet, exercise and daily routines.

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. The registered manager monitored people’s health and social care needs and any changes were recorded in care plans with all staff being informed. People living at the service were all young adults and their ongoing needs were changing as they approached the end of their time attending the college. Relatives of people were involved in discussions with managers and staff about these changes and the most appropriate ways to continue to safely support people. It remained important to give people options in terms of activities, food, changes to routines that were decided by them but not so many options as to confuse people. People were provided with options about where they wanted to spend their time at the service, where they felt most comfortable at certain times of the day and whether they wanted the company of others or needed some quiet time to themselves.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. The registered manager told us they were improving and updating mental capacity assessments for people. Some assessments were generic and not decision specific. There were some assessments that had been updated and these were fit for purpose however there was still some work to do to complete all of the assessments and for them to be fully embedded in daily life for people at the service. A relative said, “They are updating the mental capacity assessments and I want to be a part of the decision making. It is getting more detailed and (person) can’t make these decisions for themselves.” The registered manager acknowledged that people had fluctuating capacity and at certain times of the day were able to make decisions quite clearly but at others required support. Staff were aware of the importance of gaining consent from people before supporting with a task or activity. A member of staff said, “I support and encourage but if they say no then no. If no to a shower maybe wash or bath, or maybe try later in the day. When supporting with something new, talk before about what is going to happen. We use body language as indicator too. Always get consent and never force people to do anything they do not want.” Each person had a ‘restrictive practice reduction plan.’ These documents provided details of alternatives to restrictions, allowing people to be as free as safely possible to live their lives as they chose. Deprivation of Liberty Safeguards (DoLS) were in place and were reviewed regularly.