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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.

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 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.

The service carried out thorough and person‑centred assessments to ensure people’s needs were fully understood before care was delivered. They worked closely with people, their families, and relevant health and social care professionals to gather a complete picture of each individual’s needs and preferences.

The registered manager explained there was a strong emphasis on ensuring the person’s own voice was central to the assessment process, rather than relying solely on the views of relatives or others. This helped to ensure care was tailored to what mattered most to the person and respected their choices and independence.

Care plans reflected a holistic approach to assessment. They clearly documented a wide range of needs, including communication, health conditions, medicines management, food and nutrition, and mobility. This ensured staff had comprehensive and accessible information to provide safe, effective, and personalised care.

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 service delivered care and treatment in line with current evidence‑based practice, supported by the knowledge and leadership of the management team. Whilst nationally recognised tools such as the Malnutrition Universal Screening Tool (MUST) and the Waterlow tool for assessing pressure damage risk were not formally used, the risks associated with malnutrition and pressure damage were effectively identified, assessed, and managed.

The management team demonstrated an excellent understanding of best practice guidance and ensured this was embedded into both care planning and the day‑to‑day delivery of care. Care documents reflected up‑to‑date approaches to risk management, and staff were supported to apply this knowledge in practice to maintain people’s safety and wellbeing. The registered manager showed a thorough awareness of current legislation, national standards, and clinical best practice. They were able to confidently describe how these informed the care provided and how they ensured the service remained up to date with developments in the sector. This proactive approach helped drive consistent, high‑quality care.

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 service worked effectively in partnership with a range of professionals to ensure people received coordinated and consistent care. Records showed good communication and collaboration with health and social care professionals involved in people’s support, helping to ensure all aspects of their needs were met.

Staff demonstrated a proactive approach to maintaining continuity of care during periods of change. When people moved between services, including hospital admissions or transitions to other care settings, the service actively supported these processes to ensure they were smooth andwell‑managed. This helped minimise disruption and ensured people’s needs continued to be met.

The service also went beyond expected practice to maintain relationships and provide reassurance to people during these transitions. Staff visited people when they were admitted to hospital, ensuring continuity and supporting their wellbeing during what could be an unsettling time. This approach reflected a strong commitment to person‑centred care and effective multi‑agency working.

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.

The service supported people to maintain and improve their health and wellbeing through person‑centred care and practical support. Staff had a good understanding of people’s health conditions and worked with them to promote healthier lifestyles that met their individual needs.

We saw evidence of staff supporting people with specific health conditions, such as diabetes, to manage their diet effectively. This included encouraging healthy, low‑carbohydrate food choices in line with guidance to help people maintain stable blood sugar levels. Staff demonstrated awareness of dietary requirements and took care to ensure people received the correct foods. One staff member told us, “I have a few clients that are diabetic and gluten free. Each time I visit I will ensure to monitor their sugar intake with food given and medication if needed. My client that is gluten free lives with their spouse who isn’t, therefore has separate food to them. I always double check they are given the correct bread and food as to not cross contaminate and cause medical issues.” This showed a detailed and attentive approach to managing people’s nutritional needs safely.

People were also supported with aspects of personal health care. One person told us staff who were specially trained, supported them with foot care, saying, “One of the staff looks after my feet. It’s easier than going to the chiropodist. I hate having my feet touched but it’s easier if it’s someone you know.” This demonstrated how familiar staff could help people access care in a way that was comfortable and acceptable to them.

The service worked proactively with healthcare professionals to support ongoing health needs. One relative told us, “[The service] has put in place a process for getting medical professionals in every four weeks.” This ensured regular health monitoring and timely intervention where required.

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 service had effective systems in place to monitor, review, and improve outcomes for people. There was clear evidence that people’s needs were regularly reviewed, both as part of scheduled annual reviews and in response to any changes in their circumstances. These reviews considered people’s individual goals and desired outcomes, as well as the progress made towards achieving them, ensuring care remained relevant and person‑centred.

The registered manager explained that reviews were always carried out face to face, enabling meaningful discussions with people and their relatives. This approach supported open communication and ensured people’s views and experiences were fully captured. In addition, six‑monthly quality audits were conducted in person, providing further oversight of care delivery and identifying opportunities for improvement. People and their relatives confirmed this approach was consistently followed and told us they felt listened to and involved in decisions about their care. One person said, “They have a very good system that means I can put any issues to them on an email, and they’ll ring back immediately to let me know of changes they’ve made.”

The service responded promptly and effectively when people’s needs changed. One relative told us, “They reviewed the care within the first two weeks of starting.”Another relative said, “Currently [person’s] in hospital. They were admitted due to a tumble at home and were put forward for a discharge to assessment bed. Whilst in the hospital staff have been taking it in turns to visit then.” This demonstrated the service’s ability to act quickly, work collaboratively with professionals, and ensure care was adapted to meet people’s changing needs with sensitivity and dignity.

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

The service worked in line with the principles of the Mental Capacity Act (MCA) to ensure people were supported to make decisions about their care wherever possible. Where people may have lacked the mental capacity to consent to specific aspects of their care, appropriate mental capacity assessments had been completed. These showed staff had made reasonable and practical attempts to explain care and treatment, sought consent in accessible ways, and clearly recorded people’s responses. This demonstrated that capacity was assessed as decision‑specific and in line with legislation.

Where people were assessed as lacking capacity, best interest decisions were documented to guide care delivery. These records generally demonstrated involvement from relevant parties and considered the person’s needs and wishes. However, in one case, there was no evidence in the records that the option of the person not receiving care from the service had been considered. This meant not all potential alternatives had been fully explored or documented, which limited assurance that decision‑making processes were always fully comprehensive. Despite this, staff demonstrated a good understanding of consent and the MCA in practice.

Staff described how they supported people to make their own decisions wherever possible and recognised when to escalate concerns. One staff member told us, “I ensure to follow the mental capacity act abiding by the mantra that every client has capacity unless medically unable to make their own decisions regarding the care they receive. If any concern is raised due to mental capacity I will escalate this to the office who will follow the correct steps to have a capacity reassessment.”

People’s choices and preferences were respected in practice. One person told us, “There was an occasion when they wanted to introduce a new carer and I said I didn’t see the need. So, they didn’t.” This showed the service listened to people and respected their decisions about their care and support.