Turning Point - City of Manchester Learning Disabilities Supported Living

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 registered in July 2024. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (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 were assessed prior to admission. After admission, the managers and staff gathered further detailed information through discussions with the person, spending time getting to know them, observations, input from families, relevant historical information, and contributions from health and social care professionals. The service considered people’s past experiences and how these continued to affect them. This information contributed to comprehensive and detailed care, support, and communication plans.

Care records were reviewed every six months, or sooner if people’s needs changed.

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 provider followed best‑practice guidance and worked closely with health and social care professionals, including speech and language therapists, GPs, district nurses, hospital teams, housing and social workers. The manager promoted a proactive approach to care, which included establishing monthly discussions with the GP and district nurses for all people.

Records we viewed evidenced that staff and managers had identified changes in one person’s behaviours. They shared this information with the appropriate agencies, and staff received training to meet the person’s changed needs and provide a consistent approach to care. The person’s family was kept informed, and staff sought ongoing advice from relevant health professionals.

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.

Managers and staff worked collaboratively with people, families, and other services to ensure people received consistent care that met their needs. Input from partner agencies was documented and shared through their electronic recording systems, dedicated electronic channels for each bungalow, daily handovers, and team meetings. Staff confirmed they received information in a timely manner. Some staff said they would like more time to read plans when they came back from leave.

Managers demonstrated strong multidisciplinary working. They were knowledgeable about services and facilities in the area and maintained close relationships with other professionals. These connections ensured prompt referrals were made to the right people at the right time. As a result, support was well coordinated, professionals had the information they required, and responses were timely.

Records showed clear communication and advice between professionals. Staff signed electronic records to confirm they had read and understood care plans and updates, enabling consistent delivery of individualised care.

Feedback received from professionals about the service was very positive.

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 demonstrated a good understanding of the health inequalities experienced by people with a learning disability and autistic people. They supported people to access the healthcare and treatments they needed and made respectful, purposeful challenges to health services when required which led to improved outcomes for individuals.

Staff arranged and attended appointments with people, sharing and recording information as necessary. Families also attended appointments where possible, and when they could not, staff ensured they received prompt updates. Families told us they received good information from staff who knew their relative well.

People’s files contained clear information on health needs, health checks, and upcoming and past appointments. Records included annual health assessments and medicine reviews.

For one person who declined a daily treatment for an illness, staff followed a detailed care plan and risk assessment. A least restrictive best‑interest decision, agreed with health professionals, provided clear guidance for staff on the signs and symptoms of the illness, what to monitor, the actions to take, and when to seek emergency support.

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.

People were supported to live the lives they wanted. Staff discussed and recorded people’s goals, wishes, and aspirations in their care plans, along with how they could support individuals to achieve them. There were good examples of people gaining new skills and increasing their independence. One person successfully went abroad on holiday for the first time, and two other people enjoyed a holiday together in the UK. Staff supported them to make informed choices and assisted with planning, budgeting, and travel arrangements. These trips were successful and helped build people’s relationships, confidence, and experiences.

The service had systems in place to monitor and improve outcomes for people. The electronic recording system included allocated daily time for support around specific areas. For example, one person was working to develop a better understanding of money. Staff spent time each day teaching counting and money‑handling skills and uploaded photos of the activity to the system with the person’s consent. This provided a clear record of progress and enabled effective monitoring.

People were also supported and encouraged to develop new skills and independence in a range of areas. There were numerous examples of this across the service. People were trained and supported to take part in recruiting new staff, completing initial screening phone calls, carrying out face‑to‑face interviews, and phoning the successful candidate to offer the job. One person had a role involving fire‑equipment safety checks, fire alarm testing, and making recommendations for improvements that were acted upon. They were also involved in podcasts and worked as an inclusion advocate. All people contributed to the monthly magazine, sharing updates, photos, interviews, reviews, advice, and jokes.

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

The service promoted a culture of choice. They protected people’s rights to make decisions and explained how they sought verbal consent for day‑to‑day activities. This included knocking on doors before entering, asking people what they wanted to do, explaining any intended support, and seeking their agreement. People we spoke with told us they made their own choices.

Where people were unable to make specific decisions safely, managers completed capacity assessments, involving families and relevant professionals to agree the least restrictive best‑interest decisions. This upheld the principles of the Mental Capacity Act, which protects and promotes people’s rights and dignity.

Staff knew people well and understood what they could and could not consent to. They also knew which individuals had a relative or professional with legal authority to act on their behalf, and in what circumstances. Families told us they felt fully involved in decision‑making. One relative said they were “Always [involved in decision making], I have made this a priority that I am always involved… particularly in major decision making.”

Staff received training and annual updates on the Mental Capacity Act to reinforce compliance.