United Support Services

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 outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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 clearly considered as individuals with their own unique needs and preferences. Care plans included detailed information about people’s physical and emotional needs. The plans were reviewed monthly and in response to any changes to help ensure they remained relevant. Staff told us the care plans were accurate and a good reflection of people’s needs. One commented, “If there is anything I’m not sure of, I will always go to the care plan. Managers will let us know if anything has changed straight away.”
Positive behaviour support plans had been developed which focused on guiding staff on how to recognise when people were becoming distressed and supporting them to manage their distress.

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. They worked to develop evidence-based good practice and standards.

Managers kept up to date with guidance and demonstrated a good understanding of the principles underpinning the supported living model of care and supporting people with learning disabilities and autistic people. The registered manager spoke of working in line with Reach standards, a set of human rights based guidelines designed to help ensure people live an ordinary, self-directed life. People had easy read tenancy agreements. The registered manager spoke of the need to ensure a communal space was kept for use by the tenants and not allowed to become a staff space.
Staff worked in line with Right support, right care, right culture. Choice and control underpinned the staff approach to providing care and support in line with people’s preferences. People were supported to take part in activities in the local community and live a fulfilling life.
Some staff had completed accredited Positive Behaviour Support (PBS) training and worked as PBS leads. Rotas were arranged to help ensure there was always 1 PBS lead on shift. They took responsibility for completing charts used to record incidents and behaviours of concern. This helped provide a consistent approach to recording which then supported effective data analysis resulting in good outcomes for people. The registered manager explained, “If staff involved in incidents are recording straight away, they may be heightened so we aim to have a PBS lead on shift at all times. Staff can contact the PBS practitioner and they record it. They are trained in supporting staff following an incident.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

External professionals were highly complimentary of United Support Services. Comments included, “I feel this is one of the best services I have been involved with” and “The strongest aspect of the service, in my view, was its person-centred culture and focus on enabling people to achieve more, rather than simply maintaining existing care arrangements.”
The provider had worked closely with other agencies, and families, when supporting people to start receiving care from United Support Services. They had worked alongside staff where people had previously lived, to develop an understanding of their needs and how they were being supported. When leaders had identified how people could be supported differently to improve their experiences, they had worked closely with other professionals to ensure this was done at a pace people were comfortable with and would not cause distress.
External healthcare professionals had completed a report for one person looking at sensory needs and activities. Staff had used the report to develop activities which were appropriate and helped enrich their life. For example, “We encourage [Name] to play Connect 4 rather than use the [computer]. It’s not about the Connect 4, it’s about the engagement and the interaction.”
Staff told us they communicated well as a team and were always aware of any changes in people’s needs.

The provider always supported people to manage their health and wellbeing to fully 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 were actively encouraged and supported to maintain healthy lifestyles through meaningful and engaging opportunities. One person had been reluctant to take part in exercise and had been identified as being at increased risk of health problems associated with limited activity. Staff had worked alongside occupational therapists to identify an activity the person would enjoy in an environment that was calm and private. Before the person was supported to visit the venue risk assessments were developed and a social story created to prepare the person for the experience. This approach resulted in a successful experience which staff built on over time. The person is now regularly participating in this activity, their confidence has increased and it has become an enjoyable part of their life.

People were encouraged to eat well, and 1 person was a regular attendant of a weight loss club. Staff helped people prepare well-balanced healthy meals while respecting people’s choices.

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

Monitoring was used to gather and collate information which could then be used to improve outcomes for people. Leaders ensured information was meaningful, was used to learn from experiences and measure how successful approaches had been. For example, staff had noticed 1 person’s use of verbal communication varied. Staff began to monitor their use of words and identified this decreased if they were unwell. More focused monitoring then found, if the person was given longer to process information at these times, their ability to communicate improved. Care plans were updated with information to guide staff on how to better support the person with communication when they were unwell.
There was a focus on active support and doing ‘with’ people and not ‘for’ people. One person responded particularly well to staff modelling behaviour. For example, they did not always take enough fluids and were at risk from dehydration. However, if staff prompted them to have a drink they could perceive this as a demand which could cause distress. Staff had identified if they had a drink themselves, the person would often sit down with them and finish their own drink.

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

People’s communication styles were well understood by staff. These were taken into account when staff assessed if people were comfortable with the support being offered so they could be confident people were consenting to care. Staff described how people demonstrated when they were unhappy. This information tallied with information in people’s care plans.