Wiltshire Base

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 newly registered 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 was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs had been assessed prior to any care package being started. Once people started receiving care and support, the assessment process was ongoing to help leaders identify if people’s needs changed.

Leaders shared examples of how their assessments had identified different packages of care would be more appropriate to meet people’s increased care needs. Once people’s needs had been re-assessed, leaders liaised with healthcare professionals to involve them in the assessment process.

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 registered manager was a registered nurse and maintained their qualification by keeping themselves updated with changes to legislation and good practice. Assessment tools and care planning was in line with current good practice.

People’s nutritional needs were assessed and if there were any adaptions needed to diet, this information was recorded in people’s care plans. Staff supported people with eating and drinking if this was part of the identified care package.

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.

Management were familiar with what services were available to people for their health needs. Leaders had contact with healthcare professionals regularly and supported people with referrals and ongoing health appointments.

Staff said there was good team work at the service, and they were informed about people’s needs and any changes. One member of staff said, “There is good teamwork, it is really good. If I need to work with a colleague, they are helpful.” Staff had access to an electronic care planning system which enabled them to see information that was current and up to date.

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 provider said they respected people’s human rights to make their own decisions about lifestyle choices, but they encouraged people to choose healthy options if possible and appropriate. For example, by eating healthily and if appropriate supporting people to access the gym. The provider said, “When we visit people, we encourage people to eat healthily. Having that conversation with people can prompt healthy habits.”

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 had regular reviews of their care packages which enabled changes to be made in a timely way. People were supported by a consistent team of staff which meant they knew and understood people’s needs. Staff reported any changes to leaders for any actions to be taken to help improve people’s outcomes.

One relative told us, “They [staff] understand what to do, they treat [person] as a human being. We have seen improvements in [person’s] quality of life. I can sleep at night knowing they are well looked after.”

Where people lacked capacity to make their own decisions, records did not always demonstrate the principles of the Mental Capacity Act 2005 (MCA) had been applied. Whilst the provider was able to discuss what actions had been taken in people’s best interest, this process had not been recorded consistently. This meant there was no record of who had been involved in decision making and what options were discussed for people. This meant the provider did not have a record to demonstrate staff were following least restrictive options. For 1 person the provider had a copy of an MCA assessment completed by the local authority. However, this was decision specific and did not include all decisions that had been made for the person in their best interests.

Leaders and staff had completed training on the MCA and were aware of how the principles applied to their work. One member of staff said, “We don’t assume the client does not have capacity to make decisions. Treat people with respect as you are in their home.”