Ash Tree

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 75 (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. Staff took time to meet people, their relatives and those involved in their care to understand what was important to them prior to any admission to the service. The registered manager told us they considered the impact of every new admission on existing people within the service as part of any assessment process.

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 and current evidence-based good practice and standards. The registered manager demonstrated they understood best practice and worked with staff to develop their knowledge and understanding. For example, positive risk taking and promoting independence. Staff were able to describe how they used personalised care approaches to understand people and improve communication and interactions. Records showed this had resulted in a reduction in frequency of people’s distress and a development of people’s communication abilities. Staff supported people and acted on concerns in a timely manner to enable people to maintain nutritional health. For example, staff identified a person was not having enough fluid each day. They implemented monitoring and prompting with the person to encourage them to drink more fluids and ensure they remained hydrated.

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. For example, staff worked with a range of agencies including health and social care professionals to support people to achieve positive outcomes. People’s care plans detailed their personal goals and aspirations, based on their feedback and on staff observations of peoples’ responses and reactions.

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 were supported to attend medical appointments to support their physical and mental wellbeing. A relative told us, “The staff are great and really seem to understand [Names’] needs and requirements; they take [Name] on all appointments.” Staff provided examples of how they had advocated for people in discussions around their health, when they felt they were at risk from discrimination due to their learning disability.

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. A person told us they liked working in the garden. They told us, “I really like doing the gardening in the front and back gardens, tidying up and doing the weeding. I go to the local garden centre on regular visits.” Staff supported a second person to maintain their health and well being as their health declined through consistent support and regular health checks.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Records showed people’s capacity had been assessed in line with the Mental Capacity Act and staff followed best interest decision processes when needed. Some people did not use words to communicate. Staff used visual and verbal prompts and gestures to support meaningful decision making. We observed staff supported people to make decisions and choices throughout our visits, for example, where they wanted to spend their time and what they wanted to do. A staff member told us, “Everyone is given opportunities to make choices. For example, I give [Name] a choice of 2 breakfasts. They will show if they decline this. I could put a known preferred option down in front of [Name] and they may show they decline this, so I try something else. Everyone is encouraged and very able to demonstrate if they accept something or not and we respond to that.” Staff ensured people did not have any unlawful restrictions on their right to freedom and liberty.