Imagine Act and Succeed

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 changed to Outstanding. 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 96 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

People were supported by skilled and experienced staff. Their needs were comprehensively assessed and included consideration of their physical, mental, sensory, social and communication needs. The assessment ensured the care plan was personalised, holistic, strengths-based and reflected their needs and aspirations. People, those important to them and staff reviewed plans regularly together.

We saw excellent records of annual reviews carried out to support people with a clear focus on their involvement and the involvement of their families. What was working well and what wasn’t working well was clearly reviewed and recorded with an action plan drawn up in response to any shortfalls or any new ideas. The person was at the centre of the review process.

When people’s needs changed, staff responded promptly to implement the necessary changes. Staff noticed and reacted to changes in people and sought advice. Relatives told us, “Through the years [relatives] health has deteriorated extensively yet the staff continue to give [relative] all the care and support [relative] needs. This is thanks to the training that staff undertake so that [relative] is always able to get the right support and the right care to match their needs.” We saw team meeting minutes where staff met to discuss changes in one person’s presentation so they could understand and respond appropriately. The person was consulted throughout and a referral made to a social worker, once the issue causing the distress, had been identified.

The feedback from health and social care professionals was overwhelmingly positive. They told us, “I have attended annual reviews, and they are held in an extremely person-centred manner using visual aids to support communication, allowing individuals to make choices realistic decisions.”

The feedback from relatives, about the assessment process, was all very positive. People’s relatives told us, “At the beginning there was in depth assessment of needs and with me and my [relative]…Yes, regularly reviewed and we had the annual review yesterday” and “We all sat down in the bungalow and the service lead went through everything and the care plan was drawn up between us.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People had achieved excellent outcomes in key areas of their care. Staff followed best practice guidance and liaised with health and social care professionals, including dieticians and district nurses, for example, to help ensure people’s care met expected standards. One person told staff they had gained weight during the covid pandemic and wanted to lose weight as it was getting them down. They joined a local club to support them and staff supported them with healthy meal plans. In 2024 [person] won Slimmer of the year at their club as they had lost over 2 stone.

People’s nutritional and hydration needs were being met in line with current standards and evidence-based guidance. People were involved in planning healthy food menus each week and were supported to manage their dietary needs and associated risks.

Documentation to manage people at risk of choking was excellent. A 1-page document detailed all the essential information required to keep people safe and included who to contact for further support and guidance. This was replicated in the kitchen area and was accompanied by up to do date best practice guidance.

Staff had the right skills. One person had a rare genetic disorder and family told us, “Staff have gone to conferences to listen to the professionals talk about the syndrome.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Plans for referral, discharge and transition considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. Support was planned well in advance and a consideration of reasonable adjustments was built into each person’s care and support.

Staff were proactive in working with other services when multidisciplinary involvement was required, and any actions were followed up on as needed. Input from partners or other services was clearly documented and shared with staff through handovers and communication books.

The provider had numerous examples of positive partnership working which had led to improved lives for people. They supported someone with advanced dementia, who had moved onto palliative care. Over the last four years they had worked closely with the learning disability occupational therapist, speech and language therapist, and the social worker. This multi-disciplinary approach had kept the person at home and staff received support and training to equip them to support them with the individual’s changing needs. The MDT has consisted of the same staff from IAS throughout this time which had been invaluable.

The senior managers had all worked for IAS for many years. They had built strong bonds with other local professionals, and this had impacted positively on the provision of care within the service. We received a high volume of feedback from health and social care professionals, and all the feedback was very positive. They told us, “My experience is that they make good use of professional appointments, for example support people to attend reliably, cancel or make us aware if someone will not be able to attend, and make sure that the relevant people are there – for example, in meetings which involve wider consultation with the staff team will make sure that these are well attended by their staff” and "As a professional I find IAS to be a really responsive, person centred and a proactive service.”

Care plans and care records were clear and recorded multidisciplinary team meetings (MDT) and communication between professionals. Information was shared effectively with staff through handovers, team meetings and communication books. We saw records where staff had signed to say they had read and understood people’s care plans. This enabled staff to consistently provide people with individualised care that met the persons needs and achieved the outcomes the person wanted.

The provider always supported people to manage their health and wellbeing to fully 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 had dedicated care plans focusing specifically on their health. This included details of health professionals involved in their care, how often they had attended appointments and what support was needed to attend appointments. Staff identified risks to people’s health and wellbeing and prioritised support to prevent deterioration as much as possible. They made sure referrals to appropriate health services were made quickly when people’s needs changed and acted swiftly on their recommendations.

Staff went the extra mile to ensure people were supported with reasonable adjustments so they could access care as comfortably as possible. One person was able to have a blood test and to access vaccinations for the first time as the Doctor from the hospital had agreed to carry out the treatment in a car in the hospital car park.

Care plans and records evidenced excellent communication and liaison between the service and health professionals ensuring improved health outcomes for people. Families gave us many examples of people being supported to live healthier lives. They told us, “[Relative] was previously obese. Since they have been in this accommodation, [relative] has a new GP who understood his medication and needs. Now he has lost weight. He’s in a really healthy condition”.

Staff effectively empowered and supported people to be as involved or manage their own health, care and wellbeing needs as much as possible. For example, well attended tenants meeting supported people with understanding and carrying out health self-checks.

One person had developed a belief they could not achieve things due to being partially sighted. When they moved to IAS staff supported them to learn different skills and built up their confidence. They had previously been told they could not run in case they tripped. When they mentioned this to staff a risk assessment was quickly produced and they now run weekly with staff. They have since participated in the ‘race for life’ (cancer research) and raised money for charity.

The provider 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.

People were supported to live the life they chose. They were also supported to gain new skills. This both improved their confidence and wellbeing and increased their independence. The work carried out by staff was transformative. One person had struggled with life before moving into IAS. Their autism diagnosis came late in life, and they were severely depressed. Their progress in life had been inhibited by a lack of support tailored to meet their needs. They had been too scared to use public transport and had never lived alone. Staff provided the right environment for them to gain confidence and to flourish. Within 6 months they had joined a gym, lost weight, started taking pride in their appearance and started using public transport alone. Within 1 year they had progressed from 24-hour support to living in a flat of their own. They are now leading an independent life with minimal support.

Staff worked in partnership with people and their social workers to improve all aspects of their care. People had clear goals and had been supported to make progress in all aspects of their lives. Annual reviews had a clear focus on the goals people wanted to achieve and also their dreams. People were supported to achieve both. One person enjoyed a trip to London last year which included a Solstice trip to Stonehenge. Visiting Stonehenge to experience the summer solstice has been their dream for many years.

The provider shared numerous examples where people had been supported to flourish and to live their best lives. They excelled at meeting the requirements of ‘Right support, right care, right culture’ guidance. People were respected, they had choice and control, their independence was promoted, and they had good access to their local communities. Staff were creative and innovative. One person enjoyed a trip to Stonehenge so much they wanted to return. It was used as an opportunity to build friendships and 3 people were supported by 2 staff to attend the following year. The service leader explained, “We met before the trip and planned an itinerary, but we also saved some time for spontaneity. We went to see Cabaret at the theatre, went on a Jack the Ripper Tour, ate at a very posh hotel for breakfast one morning…We all had a blast, and the actual Solstice experience was truly unforgettable… The trip went so well [the 3 people] got on so well together that they are planning their next trip in 2026!!”

Staff monitored outcomes related to people’s quality of life, including those linked to their aspirations and skill development, with a view to improving these outcomes when possible. One person with a mild learning disability had lost their long-term housing partner. They were adamant they wanted to remain living in their home and were supported to do so. Additional support was arranged immediately, and they were supported through a very detailed, “staying safe at home” risk assessment. They attended a basic first aid awareness course and assistive technology was utilised to help deal with any emergencies. The support provided by the service enabled the person to live alone for the first time and remain their home. Staff recognised it had been a tough year for this person and wanted to cheer them up. They went the extra mile and supported them to attend the Kings Garden party at Buckingham Palace. They met Prince William, Zara and Princess Catherine.

The provider 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.

A human rights approach was integral to their overall approach to the Mental Capacity Act. The importance of knowing people well, focusing on the least restrictive option and taking all practicable steps to support people to make their own decisions, where possible, was central to this. Decision making profiles for each person were very person centred and helped to ensure all practicable steps were made to support people to make their own decisions wherever possible.

The service struck the right balance between keeping people safe and maximising the freedom they could enjoy. Each person had a person-centred restrictive practice assessment to help ensure the least restrictive approach was adhered to. Records of restrictive practice and audits helped to ensure any restrictions were kept to a minimum and were in people’s best interests.

People were supported to complete person-centred consent forms provided in easy read formats. These covered all aspects of their care and enabled people to consent where they were able to and supported staff to act in best interests where required.