Options The Old Vicarage

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• 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 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 67 (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 assessed people’s needs and created care plans to show how these needs would be met. People were asked for their views. Care plans were appropriately detailed and clear. Staff understood people’s needs and how to meet these. Relatives told us they were invited to reviews to discuss people’s care. Some relatives explained this had not always happened. However, they told us that they felt involved at the time of our assessment. They said they had recently had opportunities to contribute their views.

People did not always receive evidence-based care and support. The service could not demonstrate they were meeting all the principles of Right support, right care, right culture. For example, staff did not always focus on quality-of-life outcomes which were adapted. People did not always have support to development meaningful and challenging goals. However, staff undertook a range of training. This included training about people with a learning disability. Staff understood and used a range of different communication techniques. Staff worked closely with specialist teams to understand how people expressed anxiety. Staff told us training was helpful and informative. Their comments included, “The training here has been really good” and “Things were explained clearly so we could understand this.” Relatives told us staff were well trained.

Managers told us they were sourcing additional training to help enhance staff skills and knowledge.

Care plans reflected good practice guidance and staff were familiar with this. Managers met with staff to discuss best practice guidance.

Whilst staff told us they supported each other. Some staff felt there was not always effective communication with managers. There were systems to help ensure staff shared information. These included regular meetings, handovers and written communication. Staff worked seamlessly and well throughout our visit, sharing tasks and helping each other to make sure people’s needs were met.

Comments from staff included, “Communication is good here. We have a morning handover and meetings” and “The staff team is very connected. We know each other’s strengths.” Most staff explained managers were supportive and gave them the information they needed to understand their roles and responsibilities. Some staff felt communication from managers needed to be improved. We discussed this with the management team. They explained they were working to resolve communication barriers.

Staff shared information with external professionals when needed to help ensure people received continuity of care.

Staff supported people to live healthier lives. They had assessed and planned how people needed to be supported with various healthcare conditions. People had regular appointments with their GP and other healthcare professionals. Staff supported people to attend appointments. Staff recorded information from other professionals and included this in people’s care plans. Relatives told us they felt the staff were good at monitoring people’s health and responding to changes in this.

The provider had recently improved the availability of fresh food to help provide a healthier and more varied diet for people. Staff supported people to prepare their own meals.

Staff monitored people’s health and wellbeing. They recorded information about people’s wellbeing and the care they provided each day. Each person was assigned a key member of staff who supported them to develop personal objectives. The staff monitored people’s progress towards these. The management team explained they were supporting staff to help develop more person-centred objectives for people.

Staff monitored people’s health. They liaised with healthcare professionals and families to discuss healthcare needs. Staff monitored people’s weight and nutritional intake. The management team told us they were looking at ways to improve monitoring further. Staff kept records of incidents and when people became anxious or upset. They monitored triggers for distress to help plan for future care.

The provider assessed people’s mental capacity to make different decisions. Staff considered people’s individual communication needs and tried to present choices in a way people could understand. We observed staff offering people choices and respecting their decisions.

People lacked the mental capacity to make complex decisions. Staff told us they liaised with their representatives to discuss the best interests for each person with different decisions. Staff completed training to understand about their legal responsibilities and were able to explain these to us.

Relatives told us they were involved in important decisions.