Aspire Hub 3

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (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 did not consistently ensure that people’s care and treatment were effective because their health, wellbeing, and communication needs were not always reviewed or discussed with them.

Although people’s needs were assessed before they began using the service, we found support plans did not always provide clear, practical guidance for staff to deliver care appropriately. In some cases, plans were overly complex, contained conflicting information, and were not updated to reflect people’s current needs.

We also found that governance and auditing processes lacked sufficient oversight. Leaders had not ensured that care plans were accurate, specific, and fit for purpose, leaving staff without the clear direction required to deliver safe and effective care.

The provider did not consistently plan and deliver care and treatment in partnership with people, nor did they always take account of what was most important to them.

We found people’s weight was not being monitored appropriately to ensure pressure-relieving equipment was set correctly. Although there was no impact on people this had the possibility to impact on people's skin integrity.

Staff were in the process of receiving training to strengthen practice and align with current legislation. This included mandatory training on learning disability and autism in line with the Oliver McGowan Code of Practice, as well as best practice training in Positive Behavioural Support (PBS). PBS is an evidence-based approach that seeks to understand the reasons behind a person’s behaviour by assessing the social and physical environment in which it occurs, incorporating the views of the individual and those involved in their care, and using this understanding to develop support strategies that improve quality of life for everyone concerned.

We received mixed feedback from staff regarding training. Some felt the training provided was appropriate and equipped them to meet people’s needs effectively, while others considered the online training inadequate. Most staff agreed that face-to-face training was generally of good quality and gave them the practical skills required to deliver safe and effective care.

The provider generally worked well across teams and services to support people, ensuring individuals only needed to share their story once by transferring assessment information when they moved between services. However, we identified gaps in communication about people’s daily needs. For example, when someone had attended a GP appointment or received treatment, this information was not always shared effectively among staff.

We also observed inconsistencies in care planning. One person showed signs of distress related to clothing in their room. Although we were told professional advice had been sought, there was no evidence of this in their support plan. This lack of documentation meant staff did not have the necessary information to provide consistent and appropriate support.

A relative commented, “I wish they would have a better system in place to ensure that all staff know what has been going on for [person] that day. The regular staff usually know, but I don’t think the agency/ bank staff look at handovers or any communication, so they don’t know what’s been happening.”

The provider generally supported people to manage their health and wellbeing, helping them maximise independence, choice, and control. Staff encouraged healthier lifestyles and, where possible, worked to reduce future care needs.

We observed evidence of meal planning and practical support. For example, one staff member provided hand-over-hand assistance to help a person prepare a blackberry crumble. A meal planner displayed on the wall had been agreed with the people living there, and staff confirmed that changes to the plan were respected. We saw this in practice, with staff adapting meals based on individual preferences. One relative told us, “Staff came up with the meal planner and pictures of the meals [person] enjoys. It is a balanced planner. These help [person] pick a meal.”

People were mostly supported to access healthcare services, and staff generally worked well with external professionals to facilitate medical appointments. However, feedback from relatives was mixed. While some confirmed that appointments were attended as required, others reported missed appointments or said they had been asked to accompany their loved one themselves.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

The provider identified people’s outcomes as part of the support planning process through a specific goals and outcomes support plan; however, this was inconsistent. Some people’s support plans included goals linked to health and well-being, and aspirational goals such as a holiday and travelling. Whilst other peoples lacked information or information was conflicting.

The provider confirmed that they are in the process of moving over to a new digital care planning system and that information on this will identify peoples’ specific goals and outcomes.

The provider did not consistently inform people about their rights regarding consent, nor did they always respect those rights when delivering care and treatment.

Although mental capacity assessments (MCAs) and best interest (BI) meetings were completed for individual decisions, the assessments we reviewed were not always carried out in line with the two-stage test of capacity required by the Mental Capacity Act.

There was also insufficient evidence to show how people, their relatives, or representatives had been involved in these decisions, or how communication needs were considered to help individuals understand the choices being made.

It is important to note that this had no impact on people’s everyday lives and people were choosing what they wanted to do and how they wanted to do it.

We shared these findings with the registered manager, who assured us that steps would be taken to support the team in addressing these shortfalls.