Creative Support - Sonali Gardens Extra Care Service

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 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. Initial assessments recorded people’s needs and how their health conditions were managed.

Leaders described working with people, social workers, the housing team and other relevant parties before admission to establish whether the service could meet the person’s needs. Assessments considered matters including health history, medicines and whether the person required an independent living or care home setting. People were kept informed about moving in, and their consent and preferences, including whether they wished to remain with their existing GP, were discussed.

Care plans were reviewed after 6 weeks for people new to the service. They were then reviewed annually or sooner when people’s needs changed. People, relatives and relevant professionals were invited to reviews, and the provider used surveys and meetings to seek feedback. Staff received information about changes during handovers and read and signed updated support plans.

A relative said staff spoke with their family member about their care and confirmed, “Social services and staff are involved with [person’s] care.” The relative also said the person’s independence was promoted. Staff described assessing risks with people and recording these in personalised risk plans while balancing safety with people’s rights, choices and independence.

The provider planned and delivered people’s care and treatment in line with current evidence, standards and guidance to achieve effective outcomes.

The inspection feedback confirmed that people’s health needs and their management were recorded and that the service promoted healthier outcomes. For people with diabetes, leaders described using an individualised diabetic support plan that explained the person’s needs, changes in blood sugar levels and who staff should contact in an emergency.

Staff completed annual and refresher training relating to people’s conditions, including diabetes and mental health, to strengthen their knowledge and confidence. Staff said fire safety, risk management and medicines training had been particularly useful in supporting them to carry out their roles.

However, 1 staff member said some learning, including first aid, moving and handling and medicines, would be more effective if delivered in a classroom rather than solely through e-learning. We recommend the provider review providing in person training to support effective practices and good outcomes for people.

The provider worked effectively across teams and services to support people’s care and treatment and maintain continuity.

The inspection feedback confirmed that staff worked jointly with health professionals to discuss people’s needs and improve their health outcomes. Staff contacted health professionals directly because they knew the people they supported and could explain their current care needs. Leaders described a multidisciplinary approach involving a range of health professionals, together with regular management meetings where concerns, safeguarding matters, learning and opportunities for improvement were discussed.

There were written and verbal handovers, a communication book, an events diary and appointment records. Shift leaders helped ensure staff received relevant information, and an on-call manager was available outside normal working hours. Staff said they shared clear updates with health professionals, coordinated tasks, set goals in meetings and provided relevant information to support people’s treatment.

A staff member said they shared accurate factual information, listened to professional advice, updated professionals when people’s needs changed and kept records of what had been discussed and agreed. However, staff feedback identified that communication could be affected by the use of languages not understood by all colleagues and by some poor or illegible handwritten records. The provider should consider reviewing note taking to ensure it can be understood by all needing to review it.

The provider supported people to manage their health and wellbeing and, where possible, to make healthier choices.

Staff at the service promoted and supported healthy outcomes for people. People’s support plans recorded relevant health needs and guidance for staff. Leaders reminded staff through one-to-one meetings, team meetings and supervision to offer healthier food choices and water. They checked care notes and medicines records to make sure staff provided the agreed support. Staff also encouraged people to drink more water, reduce fizzy drinks, walk and take part in activities. Some people attended day centres where they could exercise.

Staff promoted independence by supporting people to complete tasks they could manage safely rather than taking over. This included making drinks, helping with cooking, going shopping and using community facilities. Activities, individual support and opportunities to meet others were used to reduce isolation.

A relative said staff supported their family member’s independence, while one person said staff were helping them learn to use an air fryer.

The provider routinely monitored people’s care and treatment to improve outcomes and respond when their needs changed.

Leaders kept in regular contact with staff and used feedback about people’s mobility, health and support needs to decide whether to contact social workers or request changes to care packages. Staff monitored known risks using care records and specific tools, including food and fluid charts where needed. They reported changes in people’s needs, and leaders updated care plans when the amount or type of support required changed.

The service considered people’s social and emotional outcomes. Leaders described supporting a person who had become withdrawn and isolated by offering culturally appropriate women-only activities and individual support. Following a fall, staff worked with reablement services and arranged equipment to support the person’s return home after discharge from hospital.

Staff said they learned from accidents and incidents by identifying root causes, looking for patterns, sharing learning and updating risk plans. The inspection feedback confirmed that quality assurance systems were in place and that information from these systems was used to drive improvement.

The provider told people about their care and treatment in a way they could understand and respected their right to make decisions and give or withhold consent.

Staff understood to ask people for consent before providing care. Staff described introducing themselves, explaining what they intended to do using simple language, checking whether people were happy with their care and respecting their views. They knocked before entering, explained requests clearly, allowed people time to process information and respond, and did not use pressure or coercion. A staff member said, “Consent is ongoing, so I keep checking as things go on.”

During personal care, staff explained the proposed support and sought permission, including when equipment such as sliding sheets was being considered. Where people declined, staff explained the options and respected the person’s decision. Leaders said people signed to confirm consent when they understood the decision and that care arrangements were reviewed to check whether people remained happy with their support.

Leaders reported people generally had capacity to make decisions about their care, while the local authority managed financial arrangements for 4 people. Staff feedback also showed awareness of informed consent, autonomy and the importance of adapting communication. Mental capacity assessments were in place and were reviewed regularly by staff.