31-32, Southernhay East

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

We assessed all of the quality statements within this key question. Our rating for the effective key question is good. We received positive feedback regarding staff, and people said staff respected their choices and asked for consent. Staff worked well together to meet the needs of people. Most people told us they were involved in assessing their needs and were able to state their choices and preferences as to how their care and support was provided. People and their relatives had confidence in the knowledge and skills of staff. People’s care and support was planned and delivered in line with current best practice and legislation. The registered manager and staff team wanted to continually improve the service to provide high-quality care. The service was working in line with the principles of the Mental Capacity Act 2005 (MCA) and care plans contained clear information about people’s cognitive needs. However, not all staff had completed effective training in MCA as there was no oversight by leaders of training completed. There was no evidence that this had impacted people receiving support.

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.

People and relatives told us care needs were assessed before care was provided. People told us they were given choice, and consent was gained by staff when being supported with daily tasks. People and relatives said, “We generally have the same carers, and they always ask me what I want before they do anything.” The registered manager reviewed care plans and risk assessments but there was no oversight of which files had been reviewed and when (see well led). However, care plans we saw were up to date and reflected peoples’ needs. The service had systems and processes to assess new people using the service. We found care plans contained in-depth information about health needs and people’s likes and dislikes.

The registered manager told us the process they followed when assessing a new referral; this included reviewing people's needs and preferences and matching these with staff. This included a review of whether the service could safely meet their needs. Staff told us the management team went out and saw people using the service to ensure their care plan and risk assessments provided clear instructions for staff on how to support the person. Staff felt they had enough information to meet peoples’ needs. Health professionals did not raise any concerns.

The provider had processes to ensure people’s needs were assessed before they started at the service, and these were being followed. This ensured staff could safely meet people’s needs, including sourcing specialist training if necessary.

People and relatives told us care received had a positive impact on their lives.

Staff told us they knew where to find information about people’s nutrition and hydration within people’s care plans. Nutrition and hydration care plans were detailed.

The provider was not always following best practice guidance in relation to documenting that staff had received the appropriate training and supervision to safely care for people. However, we did not find evidence of this having a negative impact on the care people were receiving. The registered manager was clear they would only provide support to people when they were confident staff had the skills to meet their needs. They told us about the process when agreeing to care for a person and sourcing additional training tailored to the person’s needs before care started. Records we viewed were comprehensive in terms of initial care planning.

Feedback we received showed staff worked well together as well as with other healthcare professionals supporting people. People and relatives felt that staff knew what to do and often completed extra tasks when asked. People’s feedback did not highlight any concerns they had about the staff and service working together.

Staff told us they worked well together to meet the needs of people. Staff knew how to report concerns about people's health if this deteriorated or how to deal with emergencies. They felt they could contact the registered manager if they needed support, although some staff said that communication could be improved. Face to face staff meetings and supervision were lacking, although support was given over the telephone from the registered manager.

In our review of people's care plans and conversations with management, we were assured the service was in regular contact with relevant healthcare professionals to meet the needs of people. Feedback we received from stakeholders about the service did not raise any concerns.

The service had to ensure staff were kept informed of changes within the service and with changes to people’s needs. The registered manager confirmed with health professionals that they had seen the care plan and could meet peoples’ needs and that there was good communication with them.

Feedback received indicated people's lives were improved by the care received. Comments included, " Yes, I do feel the carers go through everything and [the registered manager] will come out every now and again to check everything is ok and I know I can phone her anytime” and “I have got no problems with the care I am receiving at all. They are understanding and patient and if you are having a bad day they are so good with me.”

Staff supported people to have healthier lives. The registered manager and staff told us how they supported people to attend medical appointments and maintain a healthy lifestyle.

People's care was assessed and planned to ensure their needs were met. Systems were in place for staff to source support for people when they became unwell. The management team were knowledgeable about peoples’ needs to make sure prompt responses were received from the relevant healthcare professionals to enable timely support.

Staff monitored people's health and ensured their needs were met. Comments from people and relatives included, “They [the visits] have gone really well and I know I have improved a lot along the way and those carers have been partly responsible for that and my (main carer) helps me with exercises as well and shows me what to do and am a little more mobile now.” People told us staff knew what they were doing, and they were satisfied with their the outcomes of the care they received. People felt supported to maintain their independence.

Staff monitored people's health and ensured their needs were appropriately met. Staff knew how to escalate any concerns linked to people's care.

People's care was reviewed and updated to ensure people’s needs were met. The provider had processes to record people’s desired outcomes and to ensure care and support enabled each person to live as they wanted to, taking into account the person’s unique skills, strengths and goals. Records in people’s care plans evidenced this. Staff recorded the care and support provided to the person and their observations about people’s health and well-being. The management team reviewed these records at regular intervals and when peoples’ needs changed and used these to inform ongoing assessment and monitor people’s care and support. However, there was no formal system to support this.

People and relatives told us staff asked for consent before providing care. We received positive feedback from people about staff obtaining consent before carrying out support.

The registered manager told us how they obtained consent on a daily basis and how this was documented in daily records, which we saw.

During this assessment, we found a lack of formal recording of mental capacity assessments and best interest decisions. However, this information was included elsewhere in care plans to ensure staff knew what to do. We did not find any evidence of care provided to people not being in their best interests. No concerns were shared by people or relatives in relation to consent.