SUPPORTED LIVING ENABLEMENT 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 good This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The registered manager demonstrated a clear understanding of the needs the service could support and had chosen to focus on domiciliary and non-regulated care to ensure a sustainable approach to care delivery. They told us they would only consider expanding into other models of care, such as supported living, once the service was fully established.

The registered manager reflected on previous experiences where incomplete information about people's needs had increased the complexity of care packages. In response, they had placed greater emphasis on completing thorough assessments and obtaining relevant information before accepting new referrals to reduce the risk of care package breakdowns.

The provider's assessment process included meeting people before care commenced, reviewing information from health and social care professionals and assessing home environments. The registered manager also completed initial care visits to ensure care plans accurately reflected people's needs and preferences.

We saw examples of this approach being implemented effectively and received positive feedback from people about how their needs had been assessed and their care packages established.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, the provider did not always do this in line with current evidence-based good practice and standards.

People told us they were happy with the support they received with eating and drinking. Relatives said staff took a proactive approach to ensuring people had access to food and drinks, particularly between scheduled care visits. This promoted people's independence while helping to ensure their nutritional and hydration needs were met. Relatives also told us staff consistently encouraged people to maintain a healthy diet and drink enough fluids.

Care plans did not consistently reflect current good practice guidance and standards. A person's care plan recorded they had a specific medical condition, and stated staff should support them to maintain an appropriate diet. However, it did not explain the person's dietary requirements in relation to their condition or identify signs that the condition may be deteriorating and the action staff should take in response. The registered manager told us the person largely managed this condition independently, and we found no evidence these gaps had placed them at risk. However, more detailed guidance would help staff recognise signs of deterioration and respond appropriately to help keep the person safe.

Where people had other health conditions recorded in their care plans, information was often limited about the severity of the condition, its impact on their daily lives and the support staff should provide to help them manage their health needs. The registered manager acknowledged care plans could contain more detail and agreed to review these with people.

The provider did not always work well across teams and services to support people.

Communication, escalation and information sharing with other stakeholders had not been consistent, and the provider had already recognised the need to improve processes for this. For example, in response to concerns about a person's changing and escalating behaviour, the provider increased staffing support and reported concerns to the local authority. However, they were unable to demonstrate how these concerns had been followed up or progressed. This meant there was not always a shared understanding of the person’s changing needs and associated risks.

Professionals told us communication between the provider and external agencies could be improved. The registered manager was receptive to this feedback and had already begun developing systems to record professional involvement and maintain clear timelines of key events, decisions and communications when people's needs or risks changed. This would help ensure relevant information was shared effectively and that actions taken in response to changing circumstances could be clearly evidenced.

Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People's healthcare needs were documented in their care plans. Relatives told us staff supported people to access healthcare services, including arranging appointments and seeking advice from healthcare professionals when concerns about a person's health arose.

People experienced positive health outcomes because of the support they received. For example, one person's relative told us staff had helped reduce the number of falls they experienced by providing consistent support with mobility and personal care. They said this had contributed to an overall improvement in the person's health and wellbeing.

In another example, the registered manager worked with occupational therapists to improve a person's outcomes in relation to eating and drinking. This included developing a care plan that enabled the person to sit upright in bed while receiving support with meals. This helped reduce risks associated with eating and drinking and contributed to improvements in the person's nutrition, health and wellbeing.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

People told us they were involved in planning their care and identifying the outcomes they wanted to achieve through their support. For example, people described goals relating to maintaining their independence with daily routines and personal care.

Care plans documented people's agreed outcomes and the support required to achieve them. Staff demonstrated a good understanding of people's individual needs, preferences and goals and described how they supported people to work towards these during care visits. Daily records reflected the support provided and progress towards agreed outcomes.

The provider had systems in place to monitor and review people's care needs. As the service was small, the registered manager maintained daily oversight of care delivery by regularly undertaking care visits and working alongside staff. They also carried out regular care plan reviews with people to help ensure care continued to meet their needs.

The registered manager recognised the need to further develop oversight arrangements as the service grew. They told us their current electronic care planning system did not provide the functionality needed to effectively monitor a larger number of care packages and were exploring alternative systems to support more effective remote oversight of care delivery and outcomes.

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

People and their relatives told us they were involved in planning care and that their views were considered when decisions were made about how support should be delivered. People said staff always sought their consent before providing personal care.

Staff demonstrated a good understanding of the importance of obtaining consent. They told us they routinely asked for people's permission before providing support and understood people's right to make decisions others may consider unwise.

The provider had policies and procedures to support practice in line with the Mental Capacity Act 2005. People had signed their care plans to confirm their agreement to the support provided. Where another person had legal authority to make decisions on someone's behalf, the provider checked the scope and validity of these arrangements. This helped ensure decisions were made lawfully and, in the person’s best interests.