Tigh Fruin

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 meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (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. People’s needs were assessed thoroughly and on an ongoing basis. People were actively involved in planning their care, with relatives and legal advocates contributing meaningfully to decisions. One relative told us, “I have been involved in planning care and follow ups.” People had monthly reviews with their key worker to identify whether their needs had changed, and staff used picture cards to support people’s understanding and participation in these discussions. This helped ensure reviews were accessible, person centred, and responsive to people’s evolving needs.

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. They worked to develop evidence-based good practice and standards. Staff followed and implemented evidence-based approaches, including the Right Support, Right Care and Right Culture (RSRCRC) framework, to ensure people received safe and effective support. The registered manager was passionate about people living their lives in the way they chose and being free from unnecessary restrictions, which was reflected in staffs’ approach to people and the culture of the service. Staff received specialist training in supporting people with a learning disability and autistic people, helping them apply best practice in their day-to-day work. People were supported to have an annual health check with their named doctor in line with national guidance, ensuring their health needs were recognised and responded to promptly.

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. Staff worked effectively with other professionals to ensure people received timely and coordinated care. A professional told us, “I have no concerns, they communicate well about people’s needs to me.” Each person had a detailed specialised hospital passport should it be needed, and staff accompanied people to appointments to ensure key information was shared. Relatives told us, “They keep me informed by phone and then always follow up with an email.” People had clear communication plans which guided staff on how best to communicate with each person, including detailed guidance on how to support someone if they became distressed. This meant staff had accurate, consistent information to use in any setting, helping to ensure smooth transitions and continuity of care.

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. People had good access to healthcare services, including regular appointments with their GP, and the registered manager had proactively sought a suitable dentist to ensure people’s oral health needs were met. People were supported to maintain a balanced diet to improve their nutritional status, and staff used personalised approaches to promote overall wellbeing. For example, staff recognised when a person was not their usual self and used music to lift their mood, which had a positive impact and also helped the person communicate. This meant staff took an individualised approach which supported people to maintain both their physical and mental health.

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. The service had effective systems in place to monitor and improve outcomes for people. Monthly care reviews were completed, with people and their representatives actively involved, one relative said, “I am confident in the care provision and my involvement.” Care plan audits were carried out to review progress and ensure support remained appropriate, the electronic care system meant updates were recorded instantly. Staff communicated to healthcare professionals in a timely manner to improve people’s clinical outcomes. For example, seeking advice and guidance from speech and language therapists. This ensured people received effective, well-coordinated care based on their changing needs.

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment. The service demonstrated exceptional practice in supporting people to make their own decisions in line with the Mental Capacity Act (MCA). Staff used a range of personalised tools, including props, pictures and technology, to ensure people were actively involved in their care and fully understood the choices available to them. When best-interest decisions were required, these were made using the least restrictive options and always with the person’s preferences at the centre. We observed people spending their time exactly as they wished. For example, when a person chose to spend time alone in their room, this decision was respected and supported. A relative told us, “Staff support my [relative] to do as much as possible for themselves, there are no restrictions to what they can or can’t do.” Staff displayed excellent knowledge of the MCA, with one staff member explaining, “We support young people and our goal is for them to thrive and reach their potential, that starts with helping them make their own decisions. We support them to take positive risks so they can live as freely as possible.” People experienced autonomy and empowerment which meant they had true control and a significant improvement in their quality of life.