Dynamic Support

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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 – we only looked at whether people were consenting to their care and treatment in this domain to ensure they were involved in decisions about their needs and wishes. At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding although we did not look at all areas.

This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 100 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.

People were consistently being offered choice throughout the inspection they could consent to. Options provided were decision specific and communicated in a way that was personal. People could consent to attend and participate in special events such as a sports day event. Plans were already underway to plan a football tournament. Again, people could consent to the teams they were in and how much they participated. One person told us they enjoyed watching and seeing people yet did not want to join in. This choice was respected by all staff and the management.

Relatives were positive about their involvement in important decisions relating to their family members. Comments included, “The company ask me when they make decisions…if they need anything they contact me”, “I speak with carers every day. Good communication between us” and, “My wife and I make decisions.” Some relatives explained their family member had them to advocate for them.

Decisions people made could be unwise if they had capacity. For example, choosing to eat less healthy food because it was their preference. One person told us about going for fast food every week and was happy they were allowed to do this. Another person had learnt about who to let in their home when answering the door. There was a programme of learning to support this person.

Systems were in place to support those who lacked capacity or had fluctuating capacity to make decisions in their best interest. Communication to assess capacity Every discussion was decision specific and involved those important to the person including advocates, other health and social care professionals and family.

The management were not afraid to hold other bodies to account when decisions for people lacking capacity were not made following current legislation. They expressed how the person should always come first in every decision and sought advocacy when required to amplify the voice of the person. This ethos was echoed by staff we spoke with who were clear the people make decisions if they are able. They knew who to contact if a person lacked capacity.