GUTU

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 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 and acting timely when people needed support the most. People’s relatives told us how people’s care and support were organised, and how they and relevant healthcare and social care professionals were involved in this process. However, although people lived with others and sometimes moved accommodation, it was not always clear from their individual support records how this was consulted with them and how they were involved in their own support reviews. Staff provided inconsistent feedback about how ‘Right support, right care, right culture’ statutory guidance was considered in people’s support journeys and how nationally recognised standards for supporting people with a learning disability were followed.

The provider planned and delivered people’s support being mindful what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards, such as positive behaviour support, trauma-informed care and guidance on stopping the overmedication of people with a learning disability. However, some elements of service design and practice were not fully in line with the ‘Right support, right care, right culture’ statutory guidance. For example, around people’s homes in relation to the design of staff areas, staff information being on display, blanket approach to ‘house rules’ or some of the language used in people’s support documentation and by staff which did not always support people’s rights and were not always person-centred. The provider already recognised elements of service design were not fully supporting person-centred care staff provided to people and were working on addressing those issues in their action plans, for example, by implementing individual ‘support agreements’ with people, rather than blanket ‘house rules’ being in place.

The provider worked well across teams and services to support people. Staff knew people well and supported them to attend healthcare and social care appointments where required to advocate on their behalf. People’s relatives told us staff worked well with them to get to know people and their stories and to reflect this in their support plans. Staff were supported by dedicated positive behaviour team within the provider’s organisation when required. They also worked with other healthcare and social care professionals to ensure people received appropriate and timely support. Professionals working with the service were complimentary about how the service worked with them to support people in a consistent and effective way, especially when people were struggling or required increased support due to change in needs.

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 healthcare appointments, for example, to see a dentist, GP, specialist healthcare or emergency services when needed, optician or for regular health checkups. People’s support records confirmed they had regular access to a range of healthcare services as per their individual needs. A relative said, “[Staff] support [person] with everything like that and all their medical and dental needs. They’re very hot on it, actually.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent. People’s relatives and staff explained how they supported people to become more independent, for example when eating, mobilising, to do things important to them or with other day to day activities. People were supported by the provider’s positive behaviour practitioners working with staff teams. This helped people to learn to cope with difficult situations, to communicate effectively, to express themselves better and to be safe when distressed. People’s support was monitored on an ongoing basis, the practitioners worked well with staff teams and there was ongoing communication, so if people’s needs had changed, help was available for staff to adjust how they supported people. A relative commented, “[Person] can eat OK (now), [staff] might have to watch them. They are much more mobile now, and not so heavily medicated which took about 2 years to change.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We observed people being involved in their support and asked for their individual choices. A relative told us, “[Person] definitely has choice and the final say.” Staff could explain how they ensured they followed the Mental Capacity Act Code of practice by, for example, “(ensuring) the best interest of the person, use of least restrictive (support) methods, allowing unwise decisions to meet people’s preferences and (that they) would always presume capacity”. Staff knew people well and could give us examples of how they respected people’s wishes, for example, when people wanted to be alone. People’s records overall included mental capacity assessments and best interest decisions making records. However, there were some inconsistencies in how people’s consent was sought and evidenced in their support records and some gaps in best interests’ decision-making records. The provider communicated with social services in relation to any outstanding court applications for deprivations of liberty where people required specific support to remain safe and well while living in the community.