IECC CARE

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 Requires improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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. Care plans were regularly reviewed; however, on occasions we found discrepancies in people’s records, such as the wrong name. The risk of people receiving incorrect care was reduced because staff had worked with the people they supported for a long time and knew their needs well. Staff told us processes were in place to keep them up to date when people’s needs changed. However, the provider’s audits were not always effectively identifying and correcting discrepancies to ensure care plans were accurate, particularly for staff less familiar with individuals.

People’s care was not always provided in line with current legislation, national standards, or evidence-based guidance, including CQC’s Right support, right care, right culture and Housing with Care guidance. The provider had not consistently involved people in planning and delivering their care or ensure it reflected what mattered to them. They had not given people clear information about their tenancies, including the landlord and tenant arrangements or their right to choose a different care provider. The provider has since taken action to separate the housing and care arrangements and engage with people, their relatives and stakeholders about changes to tenancy agreements. Neither the provider nor staff were aware of the REACH standards. These are human rights-based standards for supported living, designed to ensure people with learning disabilities and autism can live in their own homes, make their own choices, and be part of their community.

The provider worked well across teams and services to support people. People’s care plans reflected the service worked in partnership with a wide range of external specialist services to ensure their care and support was tailored to their individual needs. One relative told us, “My [Person] is overweight and doesn’t like exercise. The mental health team have been instrumental in putting a diet in place. [Person] chooses their meals and staff ensure healthy choices. [Person] has mental health reviews and is now on antidepressants. They are the happiest and calmest they have been for a long time. Their key worker books appointments, but I take [Person] to their annual health check.”

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 medical treatment. One person told us, “I have an annual health check, I have got used to it and am quite brave.” Relatives told us their family members were supported to access healthcare appointments. A relative told us, “[Person] has an annual health check, they don’t like medical appointments, it can be a real struggle. I have stopped attending with staff as they can manage [Person] without me, and their health is good.” People were supported to make healthier choices to help promote and maintain their health and wellbeing. One person told us, “I like sausages, fish, eggs, burgers, hash browns and onion rings. I am a bit fussy about fruit, I like potatoes, carrots and peas. I know what is healthy and what isn’t.” Relatives commented, “[Person] has a gluten free diet and is particular about their food. They like English and spicy food which staff make from scratch,” and “staff encourage healthy eating and make [Person’s] diet as healthy as possible.”

The provider did not always have a robust approach to monitoring the effectiveness of people’s care, treatment and support and ensure action was taken to continuously improve it. Observation tools were used to analyse people’s behaviour, however the antecedent, before and after (ABC) charts were often incomplete, with missing start and end times, and details if PRN medicines had been administered and their effectiveness, limiting their value to address concerns and take action to improve outcomes for people.
Of the 14 people using the service, only 1 person’s records contained an up-to-date health action plan (HAP). This is a personalised, document designed to help individuals, particularly those with learning disabilities, long-term conditions, or mental health needs manage their health, identify health needs, and set goals for better well-being. Whilst some relatives were happy with the service, others told us they were not always assured their family members experienced consistently positive outcomes in line with clinical expectations and the expectations of people themselves. One relative told us, “My [Person’s] weight is an issue; they are now above their recommended weight of 15 stone. Staff have been advised by health professionals to keep their weight down due to their health conditions, but they eat a lot of fatty foods.” Records showed staff monitored people’s health, but recording needed improvement to ensure early identification of health issues and ensure opportunities to improve outcomes were not missed.
 

The provider had systems in place to help people understand their rights around consent to care and treatment, and ensure their views and wishes were considered when planning their care. Mental capacity assessments clearly showed people had been provided with information in a format they were able to understand. This helped aid decision making about people’s capacity and their ability to make informed decisions about their care and treatment. Staff understood the importance of ensuring people fully understood what they were consenting to and the importance of obtaining consent before delivering care. Managers and staff understood the principles of the MCA; assuming people have capacity to make their own decisions, unless proven otherwise, involving representatives and advocates when needed, and making best interest decisions using the least restrictive options.