April Court

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This means 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.

People looked happy. They told us they were happy at April Court. Relatives also commented on their family members being understood as individuals and being very happy there. A relative commented specifically on how staff had supported someone in a way that improved their quality of life.

People were as involved as possible in assessing their needs and planning their care and support. Where people and their families wished it, family members contributed to this process.

Staff knew people well. They understood people's care and support needs, including communication needs, and assisted them accordingly.

Assessments were comprehensive and reflected people as individuals. They considered all aspects of people's care and support needs, including support with communication and health needs.

People and their key workers regularly collaborated to review their care and support needs. This included people's hopes, ambitions and plans for the future. Assessments were up to date.

People were pleased with their care and support, as were their relatives. People told us how staff supported them with things that were important to them, such as seeing their family and friends, going to football matches or celebrating special occasions. A relative remarked on how staff had supported their family member in a way that boosted their physical and emotional wellbeing.

The management team kept abreast of current good practice. They shared this with staff through team meetings and supervision. Annual refresher training also helped ensure staff were aware of good practice.

Individual staff had volunteered as ‘champions’ of various aspects of care. These included infection control, medicines, activities, nutrition and hydration, and oral health. As champions, they received training and updates. With support from the management team, they shared these with their colleagues.

People received care and support in line with current recognised good practice. This included support with nutrition and hydration, including where people had swallowing difficulties or dietary needs.

Meeting minutes and staff supervision records reflected discussion of good practice with people, relatives and staff.

People told us staff had helped them settle and feel comfortable at April Court.

A relative described how staff had supported their family member well with their health issues, including during a hospital admission.

The service had recorded a compliment from a family member of someone who had moved elsewhere. The relative thanked staff for enabling the person to leave hospital because they had learned new skills [from a health professional] to provide the particular care needed.

The computerised care recording system gave staff ready access to people's assessments, care plans and records.

Managers and staff had supported people to have a good experience of moving into or on from April Court. Gathering and sharing comprehensive assessment information about the person's needs and preferences had been central to this.

The registered manager and senior staff had effective working relationships with commissioners, and with health and social care professionals involved in people's care.

The service had received praise from a community learning disability team professional about people's up to date and comprehensive records.

Commissioners gave positive feedback about the way the service worked with them.

People's care records contained contact details for their health and social care professionals. Records reflected regular contact with health and social care professionals, including involvement in formal care plan reviews.

Care records included people's hospital passports and care plan summaries. These contained information health staff would need to provide care in a way that suited the person. They were up to date, reflecting people's care plans.

People told us they enjoyed being active. Some people took part in sport, and some liked going for walks or swimming.

Involving and supporting people in managing their health was an integral part of how staff supported people with their needs generally. For example, someone wanted to lose weight and had increased their physical activity.

Staff knew people well and noticed signs of possible changes in their health. They responded promptly to these and supported people to access healthcare as they needed.

People's care plans included information about any health conditions they were living with and the support they needed to manage these. This included how they communicated how they were feeling. People received this support in line with their care plans, including reviews of these conditions.

People had annual GP reviews because of their learning disability. Staff supported them to access age and gender-related health screening as they wished or in accordance with their best interests.

People had regular check-ups with their dentists and opticians.

People regularly reviewed their hopes and ambitions with their key workers. They also talked about these at house meetings.

Relatives were as involved as they wished to be in reviewing the person's care, provided the person consented to this or it was in their best interests.

Staff knew people well. They regularly reflected on the impact of their work for people and considered possible changes that might be beneficial for the person.

The registered manager kept oversight of key worker meetings and care plan reviews to ensure these were happening as often as they should.

The service held a platinum rating with a nationally recognised framework for optimal care for people with life limiting conditions. Platinum is the highest level of accreditation.

There was an effective process to ensure people's care plans were relevant and up to date. This included people's regular meetings with their key worker, and their monthly turn as 'resident of the day'. Part of this was that key workers checked assessments and care plans were current, updating them as required.

Staff discussed what was important to people and outcomes from their care during their regular 1:1 supervision meetings.

People, and where appropriate their families, were meaningfully involved in planning their care and support. Their wishes and views were considered.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and the least restrictive possible. We checked whether the service was working within the principles of the MCA.

The registered manager and staff had a clear understanding of the requirements of the MCA. Staff provided care in accordance with people's consent or in their best interests as determined under the MCA.

Staff fully understood the importance of consent. They recognised the importance of seeking consent each time they provided care, and that people could withdraw their consent whenever they wished. There was an ethos of people making decisions about their care and support, unless there were grounds to think someone might lack capacity. In such a situation, staff assessed the person’s mental capacity and recorded a best interests assessment. This process involved the person as far as possible, as well as families and professionals who were involved in their support.

The registered manager knew how to refer people for support from an advocate in circumstances where this was needed.

Consent to all aspects of people's care was recorded, where people were able to give this. This consent was reviewed at least annually.

Where staff were concerned that someone might not understand the implications of consenting to, or refusing care, they followed the requirements of the MCA. This meant they assessed the person's mental capacity to consent to that care, in line with MCA principles. Where a mental capacity assessment showed a person was unable to give informed consent, staff made a best interests decision regarding what care would be provided. The person and their family and professionals were involved in deciding how to provide the care the person needed in the least restrictive way. Mental capacity assessments and best interests decisions were reviewed at least annually.

Overall, records of mental capacity assessments and best interests decisions were in line with MCA good practice. However, we found some recording omissions. The registered manager ensured these people's records were updated to reflect MCA requirements.