Better Care & Support Ltd

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 requires improvement. At this assessment the rating has changed to good.

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

The service was previously in breach of legal regulation in relation to people’s safe care and treatment. The provider had made sufficient improvements and is no longer in breach of this regulation.

This service scored 62 (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. However, communication with people using the service appeared to be inconsistent.

People’s individual needs were assessed and regularly reviewed in line with systems and processes in place which were managed by management, care co-ordinators and involved the people they supported.

We found care plans were detailed and individualised meaning that care staff could get to know people’s needs, preferences and what was important to them. These included things people liked to watch on television, and how they liked the lighting overnight.

However, feedback from people who used the service were not always aware reviews had taken place. One person told us they had had, “No reviews yet (since May 2025). [Staff] always ask me before going if I need anything else. I had a visit from the office about 3 months ago.” Another person told us, “Someone came to discuss the care plan last week. And someone else is coming on the [date]. Health, social worker, 4Life and family will be there.” This showed there was a lack of consistency with care reviews.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Care staff had received training on supporting care needs such as epilepsy and dementia; however, we did not find that training had been provided on topics such as diabetes or Parkinsons Disease. This meant that care staff may not have had enough knowledge on how best to support people with these needs.

People had received care plan reviews which collated information on people’s health and care needs, as well as people’s wishes and preferences. This was then transferred onto care plans, meaning they contained up to date and relevant information. The provider told us care plans were reviewed regularly as standard process but were also reviewed if people’s needs changed.

People had fluid targets within their care plans and care staff documented fluids consumed when they attended to provide care. This helped manage people’s hydration levels and enabled staff to see if fluid consumption needed escalating to external health care professionals for support and guidance.

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.

The provider used an electronic system for care planning and recording care. All relevant staff at the service had access to this system so they could understand people’s needs and could appropriately assess, plan and deliver their care.

Staff were proactive in working with other services when multidisciplinary involvement was required, and any actions were followed up on, as needed. For example, where people had become unwell, we saw that staff had contacted the GP or 111 for advice and support.

Records were kept of when health professionals visited, and what advice they gave people. This was shared with staff to ensure that people were given the right support.

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 with their choices and maintaining their independence.

People’s care needs including what they could do for themselves was documented in their care plan. Staff understood the importance of supporting people to maintain their independence and offering people choice, so they were empowered. For example, people were supported to self-medicate where this was appropriate. How to encourage and support this was included in their care plan. Care plans also detailed how to support people to tend to their own personal care with prompting when appropriate.

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 looked out for and considered feedback from people, their families, staff, professionals and stakeholders as appropriate when monitoring individual outcomes.

There was a clear approach to monitoring the effectiveness of people’s care, treatment and support, and action was taken to continuously improve it. We observed this through the means of care plan reviews, audits and meetings.

We saw accidents and incidents and complaints were reviewed, information analysed and improvements to care made as a result. However, people who used the service told us concerns raised were not always responded to in a timely manner. These related mainly to visit times being often late or early, or because male staff were sent when females were requested.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff had received training in supporting people’s decision making and mental capacity. One staff member told us, “I understand I'm to encourage a service user to make their own decision always and must always respect a service user’s capacity to make decisions, I shouldn't assume and make decisions on their behalf.” Staff also told us, “I ask permission before providing personal care or support with meals always.” People and their loved ones felt staff were respectful and asked for consent. One relative told us, “[Staff] will ask [them] first, ‘can we wash you or do your hair’. If [they] said no they will leave it and try again in the afternoon.” Another relative told us, “[Staff] do ask [them] first and wait till [they’re] ready. [Staff] ask [them] if [they] want to go to the toilet or if [they] want anything else.”