Northumberland Supported Living Service

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 the last inspection we rated this key question good. At this inspection 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.

Assessments were responsive and dynamic. Staff made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. They assessed people’s needs holistically, including their communication, behaviour and health needs, and used this information to develop tailored care plans and communication passports. These were regularly reviewed alongside multidisciplinary professionals such as speech and language therapists (SALT), occupational therapists and psychiatry to ensure they reflected people’s changing needs. Staff understood people’s abilities and adapted their practices accordingly. For example, people’s behaviour was recognised as a form of communication and was functionally assessed through positive behaviour support approaches. This enabled staff to interpret subtle changes and ensure appropriate support was provided.

Care and treatment was delivered in line with current best practice and supported by evidence-based tools. Staff used recognised guidance and tools to support people’s care and treatment, and there was evidence of appropriate referrals to other professionals when required. Care and treatment reflected best practice for people with learning disabilities and autistic people, including the use of positive behaviour support, and specialist clinical input. They used specialist guidance and interventions to support people’s health needs. For example, SALT input was used to improve safety around eating and drinking, reducing risks such as aspiration, and physiotherapy and occupational therapy input supported mobility and independence. There was clear evidence of improved outcomes over time. Incidents of violence had reduced significantly, supported by consistent staffing, training and improved care planning. Staff demonstrated a proactive approach to implementing learning from incidents and embedding best practice into daily care. A visiting professional said, “A couple of years ago [person’s name] behaviour became more challenging but staff just adapted their techniques and eventually they stabilised. I think they really benefit from the service being nurse-led as they really do have a handle on everything and are always keeping up with best practice guidance.”

Staff worked closely with a wide range of healthcare professionals, including GPs, psychiatrists, nurses, SALT, physiotherapy, occupational therapy and community teams. This ensured people received coordinated and holistic care. Multi-disciplinary teamwork was embedded in practice. Staff attended regular reviews and care planning meetings and contributed detailed observations to inform clinical decision making. This collaborative approach led to positive outcomes, such as reductions in medicines and improved wellbeing for people. Healthcare professionals were highly complimentary about the staff team’s knowledge of people and their ability to respond to changes in people’s conditions in a timely way. One visiting professional said, “They are brilliant. The staff really know how to work with [people’s names], who both have really complex needs and always seek our views.”

Staff acted as effective advocates, ensuring people accessed appropriate healthcare and treatment when needed. There was also strong internal teamwork. Mentorship arrangements supported new staff to understand people’s complex communication needs and ensured consistency of care delivery. One staff member told us, “The staff have helped me a lot to learn my new role and the amount of support I have been given has been immense.”

Staff were exceptional in supporting people to live healthier lives, proactively promoting good nutrition and hydration, and preventing avoidable deterioration. Staff promoted healthy lifestyles through a range of personalised interventions. For example, people were supported to improve their diet and increase physical activity, which led to reduced pain and decreased reliance on medicines. They were encouraged to engage in meaningful community activities, including swimming, using public transport and accessing local facilities. This promoted both physical health and emotional wellbeing. People’s emotional wellbeing was supported through caring interactions, and staff showed empathy and patience.

Staff worked proactively to identify and respond to health changes. They were skilled at recognising subtle signs of deterioration and ensured referrals to relevant healthcare professionals were made promptly. Innovative approaches supported people’s wellbeing. For example, staff used technology to maintain family relationships and supported people to take positive risks, such as going on holiday for the first time, improving confidence and quality of life. This showed a strong commitment to improving both physical and emotional health outcomes for people.

Staff monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. There was strong evidence of continuous improvement. Incident data was regularly reviewed, and learning was used to drive changes in practice. This contributed to measurable improvements, including a significant reduction in violent incidents over time. The management team had effective quality assurance systems in place and actively sought to improve the service. For example, they increased scrutiny of records, developed new tools such as storyboards and requested internal quality inspections to identify further improvements. Staff used a range of approaches to check whether care met people’s needs, including feedback from people, relatives and professionals. Outcomes were monitored in relation to health, wellbeing and independence, and care was adapted as needed. Staff reflected on practice and used data and feedback to constantly drive improvements.

Staff told people about their rights around consent and respected these when delivering person-centred care and treatment. They understood and followed the principles of the Mental Capacity Act 2005 (MCA) and had received training in this subject and associated codes of practice. Staff completed capacity assessments and worked with multidisciplinary professionals to make ‘best interests’ decisions when people lacked capacity. The team were making improvements to the records, so they consistently showed how decisions about restrictions were made and documented in line with best interest processes. Consent was embedded in daily practice. Staff sought consent before providing care and used tailored communication approaches to help people express their wishes and preferences. Where people were unable to communicate verbally, staff used their knowledge of people’s communication methods to understand whether they agreed to care and support being offered.