Rotherham Regional Office

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.People’s needs were assessed and care was provided in line with people’s preferences. When people’s needs were assessed, consideration was given to the physical environment people lived in, to be able to effectively support the person in their home. People’s past history and exposure to trauma was considered in their care planning, so there was a trauma informed approach to understanding people’s needs throughout assessment and review.

Care plans were reviewed to make sure the care and support provided kept pace with people’s changing needs. People’s support plans were meaningful and focused on what was important to them. People and their relatives were involved in planning and reviewing their care. Their views and opinions were respected, listened to and implemented as part of their day-to-day support. People’s plans were written with them and their input was gathered using their preferred communication style. When staff met with people to talk about their support, they considered the environment in which they did this. This helped make sure people were comfortable and relaxed, enabling them to make decisions about their care and support.

People were empowered and encouraged to share their views, future goals and aspirations. People had communication plans, so staff knew how to communicate effectively with them. Communication tools were tailored to each person and available to enable them to express their views, and wishes.

The team undertook effective assessments of people’s needs and made sure their care reflected the latest legislation, standards, and evidence-based research.The service promoted a varied diet and liaised with dieticians and other health care professionals when needed. People were supported with planning their menu and shopping. Support was given, taking into account people’s nutrition and hydration needs, and in line with advice from partner professionals.

People were supported to maintain links with their friends and family and to actively engage in their community. People and relatives told us staff were aware of people’s need and what was important to them. One relative described their family member’s preferences, saying, “[My family member] needs lots of calories because they never stop moving. They are well fed and can have snacks. Staff give them cake. Recently, [my family member] has got a taste for sweet, milky coffee that staff make for them. They go out for milkshakes. It’s their birthday soon and they will have a tea party.”

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.

Professionals were involved in the assessment of people’s health, care, wellbeing and communication needs. People were supported to live a healthy life and partner professionals were engaged in reviews and assessments to make sure relevant information was incorporated into people’s care plans. Assessments were reviewed and the staff and members of the management team facilitated discussion to support seamless services between professionals. A relative said, “Staff take [my family member] to the GP as needed, and organise their annual health checks. They let us know if [my family member] is not well.” They went on to tell us about a medicine their family member had been taking, adding, “This gets reviewed by the GP.”

The provider regularly reviewed people’s needs to consider if support needed to be adapted. Information was shared between teams and partner services to help ensure continuity of care for people. Information was passed on to staff during handovers to make sure they were up to date with current information and events, and any changes in people’s needs.

Staff told us they worked well as a team and had access to the information they needed to deliver people’s care and support. One staff member said, “Our care planning system is very easy to use, so we can see how people have been, and information about any changes or events quickly and easily, as well as whether the person has any upcoming activities or appointments we need to provide support for.”

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. The provider’s systems and processes helped staff to identify and respond to changes in people’s health and wellbeing in a timely way. Care records were kept up to date to show any trends and patterns and to review actions and progress where needed.

People had access to external health and social care professionals when they needed them. Records showed staff worked closely with local community health services and were able to access advice and guidance when needed. Staff recognised changes in people’s presentation, emotional state or distress that might indicate a deterioration in their health and wellbeing. They escalated issues to relevant professionals. The team supported referrals, and whilst they were waiting for them, they worked with people to help make sure their needs were met.

People were enabled to live their best life. Staff and managers engaged people, used all information available and asked those closest to the person about their life. This enabled support to be tailored to each person’s physical, social and psychological needs.

The team routinely monitored people’s care and support 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. People’s health and well-being was monitored, and any emerging healthcare needs were addressed as soon as possible.

People were empowered to achieve their goals. The management team had good oversight of staff skills and knowledge and were able to match staff to work with people. People’s support was delivered consistently by staff, in a person-centred way that was specific to their needs. People’s skills, life experience and strengths were discussed with them and those involved in their care, to consider how people’s goals, ambitions and outcomes were planned and achieved. Staff introduced new ideas to people to enhance their quality of life, such as new activities, skills, work and education opportunities. People were actively supported and empowered to develop new skills.

The provider told people about their rights around consent and respected these when delivering person-centred care and support. Staff involved people in their care, offered choices to people and respected their decisions. Staff explained what they were doing and checked out how people felt about the task prior to proceeding.

Deprivation of Liberty Safeguards (DoLS) had been applied for as necessary. There was a process in place to track and monitor applications and when authorisations needed to be renewed. Mental capacity care plans were in place. Where people lacked capacity to consent to particular decisions, decisions were made in people’s best interests, following good practice guidance, and were regularly reviewed.

People made their own choices and decisions on a day to day basis about what they did, what they ate and how they filled their time. People had tailored communication plans in place for staff to follow to make sure people were in control of their own lives. Staff communicated with people about their choices using objects of reference, pictures, sign language, and electronic aids. This enabled people who did not use verbal communication, to tell staff how they wanted to spend their day.

Records included information about people’s capacity and how, either through verbal or non-verbal means, they were able to refuse or give consent for specific decisions.