STEPS

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.

Assessment processes included people’s physical, medical and emotional needs, with a focus on reablement. The assessment identified goals that had been agreed with the person. These goals took account of people’s previous skills, current abilities and aspirations. As part of the assessment process, any barriers to progress were identified and where possible mitigated. Professionals said, “They will often try to see patients in hospital so they can support smooth transition of care.”

Staff were informed of any changes to people’s care needs via the providers electronic App. This ensured any changes could be made and delivered in real time. We saw assessments were regularly updated.

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.

Care staff were skilled and understood how to meet people’s individual needs. Staff had a working knowledge of current best practice and told us, “Being a reablement service we can spend longer if needed, everyone is different…. time is a guideline rather than enforced and we stay on until the person is comfortable to leave”.

People’s care plans were updated regularly and directed staff on how to meet people’s needs. One professional told us, “They are passionate about reablement and deliver positive outcomes.”

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.

The service engaged positively with people’s relatives and involved health care staff to ensure people’s care needs were met. Care staff were consistently complimentary stating, “They are very good, we get lots of emails from the supervisors, have regular team meetings and supervisions every 3 months.” Professionals were highly complementary of the services’ collaborative approach and told us, “My team and I have consistently found STEPS administrative team, along with registered manager and their direct reports, to be responsive, accessible, and constructive in their engagement.”

Staff felt supported by colleagues and managers and described a culture where teamwork was encouraged.

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 service always supported people to access health services when needed. Care staff were trained to report any changes in people’s needs, allowing the provider to respond appropriately to identified risks.

Staff made appropriate and timely referrals to support people to stay healthy. Staff followed the recommendations from professionals, who confirmed staff worked closely with them to ensure people’s health and medical needs were met. Professionals’ comments included, “Multidisciplinary collaboration with therapists and healthcare professionals is evident-following care plans to support recovery, they have always been ready to support changes to care plans to meet patient needs.”

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.

Incidents had been effectively reviewed to check outcomes were appropriate and if actions were needed to improve the care individuals received. People’s health was monitored. Staff understood the importance of reporting changes in people’s needs and escalating concerns to relevant healthcare professionals. A professional told us, “I couldn’t fault their commitment, they’ve explored assistive technology, equipment and many ways of supporting people.”

People and their relatives were consistently complimentary of the service provided. They told us, they were confident any concerns reported would be addressed. One relative said, “The manager came out to discuss what my care needs were and to understand what it is I actually need.”

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

Staff understood the need for consent before providing care. We observed staff asking people how they wanted to be supported and checking with them before providing care. Our observations confirmed staff respected people’s choices and decisions. All care was provided in the least restrictive way.