Maximus Support Services Ltd

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• 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 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 were effective by assessing and reviewing people’s health, care, wellbeing and communication needs with them and those involved in their care. Assessments reflected people’s multiple emotional and behavioural support needs and were informed by information from the person, their relatives, professionals and previous placements. A trauma informed approach was used to understanding people’s needs throughout assessment and review.

Care plans contained detailed guidance to support staff to provide personalised care and assessments were reviewed when needs changed. The provider assessed and had taken into consideration the physical environment people lived in to be able to effectively support the person in their own home.

People and relatives described staff who understood people’s health needs and adapted support. One person told us staff understood their health needs and “go on training courses.” Family members also described being involved in reviews and updates where needed.

The provider planned and delivered people’s care and treatment with them, in line with recognised evidence‑based practice and current guidance. Staff used positive behaviour support approaches, trauma‑informed practice and least restrictive strategies to support people during periods of distress and to promote independence wherever possible. Care plans provided clear guidance to support staff responses, enabling consistent and personalised care across staff teams.

People, families and professionals described positive outcomes from this approach, including improved emotional stability, reduced distress and successful transitions from hospital or previous placement breakdowns into community settings. External professionals reported confidence in the provider’s ability to deliver effective, solution‑focused support for people with significant support needs, noting good communication, proactive planning and good implementation of care strategies.

Staff demonstrated understanding of people’s individual needs and histories and described using training, supervision and specialist input to inform their practice. This helped ensure care delivery reflected current good practice and supported people to achieve meaningful progress in their lives.

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. External professionals consistently reported good communication, timely updates and collaborative working. For example, one social care professional told us, “Communication is timely, proactive and appropriate. The service provides regular updates and promptly escalates concerns, which supports effective multi‑agency working and continuity of care.”

Staff were confident they could escalate concerns and seek professional input, supporting continuity of care. Staff described using electronic systems to support information sharing so people’s records were accessible and up to date. One staff member explained, “We use (electronic system). We have the means to communicate with other staff, to make sure information is shared,” and that the office team were “quick to review the care plan.”

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. Care plans included information about health conditions, medicines and actions staff should take to support people’s physical and mental health. Staff supported people to attend health appointments and monitored changes in health. External professionals recognised positive outcomes, including improved stability and reduced hospital admissions for some people. One health professional told us the service supported people to achieve “improved stability, better overall health and reduced need for hospital admission.”

Staff actively monitored people’s physical and mental health and supported timely access to health services. This included arranging and accompanying people to GP, hospital and specialist appointments, monitoring changes in health, and adjusting support following periods of ill health.

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. People’s skills, life experience and strengths were discussed with them where appropriate and they were involved in short, mid and long term life choices, goals, ambitions and outcomes which could be planned and achieved.

Outcomes for people were monitored through daily records, audits and management oversight. Staff understood how to report changes in people’s needs, and managers acted on this information. Care staff told us how risks and changes were updated on the electronic care system, describing records as “always up to date care plan and risk information,” and that updates were “reviewed quickly by the office (management team)”.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, we found some missing or incomplete mental capacity assessments and best interest decisions in relation to some ongoing restrictions. While this did not indicate a lack of person‑centred care, it reduced assurance that consent and lawful decision‑making were consistently evidenced in records. The registered manager took action to complete the required documentation and strengthen processes to reduce the likelihood of recurrence.

Staff understood the principles of consent and routinely sought consent before providing care. People described staff asking permission before supporting with personal care. One person told us, “Yes, the staff ask before they help me if I need support.”