EVHM LLP - 25 Alexandra Road

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 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.

When people’s needs changed a full assessment was carried out to ensure staff could continue to meet them. However, one person had recently had a change in diagnosis. This affected the way in which they accessed support from professionals. The registered manager had sought advice and support to ensure the person’s needs could be fully assessed. The registered manager had identified that additional training was needed for staff, and they had been trying to source appropriate professional support. The situation was discussed at length with the registered manager who in turn spoke with the directors. Following the site visits the registered manager contacted us to confirm that a review had been arranged with the placement funders and the person’s relative to discuss the person’s needs.

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.

Staff were given training which followed best practice guidance. This included training on nutrition and hydration. Staff received regular training and updates to help ensure they understood the current standards of care to support people effectively. They demonstrated a good understanding of how Autism impacted upon people’s lives and what they needed to do to be able to deliver effective support to autistic people.

A health professional told us, “Staff are good at interpreting people’s needs and picking up subtle signs that people may be distressed or in pain.”

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.

Feedback from a visiting health and social care professional was very positive about how staff worked with them to improve and maintain people’s health. They told us, “A lot of staff really know the service users and are tuned in to changes in health. We rely on support staff to support communication. Staff respond effectively to any advice given and make appropriate referrals.”

Relatives were also positive on how staff worked with health professionals. One told us, “We have every confidence in the staff team.” A staff member told us that communication is very good between the seniors, and they keep each other up to date with changes. This is particularly important if they have not worked at the service for a while.

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.

People found attending health appointments difficult. For one person, staff made appointments and with the use of social stories they tried to persuade the person to attend. A social story is a short and simple narrative, usually with pictures to help people understand social situations, expectations and routines. Sometimes this worked but if not, arrangements were made for professionals to visit the person at the service in line with their needs. Staff supported another person for all health appointments and provided support as needed. They knew the things that gave the person confidence to take part in conversations with professionals. This did not always work but they continued to try different ways to achieve the best outcomes for the person. This person had recently successfully attended a dental appointment.

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.

Staff knew people well and monitored them daily to identify changes in their health and well-being. Where appropriate, people’s weight was checked to identify if there was any unexpected weight loss or gain. Each person had an annual health review and as part of this process a check was made to ensure people had access to any other health provision as needed.

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

There was advice and guidance within care plans about how people made choices. During our visits we observed staff asking permission before providing care. Capacity assessments were completed when needed and staff had received training and acted in line with the Mental Capacity Act 2005. When people lacked the capacity to make decisions staff had followed the principles of the mental capacity act to ensure decisions were made with those closest to them, were the least restrictive and, in their best interest. The registered manager told us that in the past best interest decisions had been taken in relation to emergency dental treatment but generally with enough time, people could be encouraged to attend appointments as needed.

Staff explained things to people in ways they understood, so they could make informed decisions about what they were consenting to. Staff knew people and knew when they wanted to participate in an activity or not. A staff member told us a person sometimes refused support with personal care. They said, “If you ask them if they would like a bath they will refuse but if you say, I’ve run you a nice bubble bath, they will often accept.”

Work was needed to one person’s bedroom floor which meant that the person needed to move from their room to another service for two weeks. A mental capacity assessment was carried out as initially it was thought the person might not understand the need to move to another service. However, once it was explained what needed to happen and why, the person accepted the situation and was happy to move.