London Borough of Hillingdon

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. The last rating for this key question was 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 assessed people’s needs and choices so that care could be provided in a person-centred way. The assessments were comprehensive and considered people’s physical and mental wellbeing. Many people had used the service for a long time. Staff regularly reassessed their needs to make sure planned care reflected these needs. Relatives told us they were consulted about care plans and reviews. Staff supported people to develop personal objectives. These were regularly reviewed, and people were supported to try new things and learn independent living skills.

The provider ensured people received evidence-based care and treatment. Staff undertook a range of training, including training about how to support people with a learning disability and autism.

Staff told us training was useful and helped them to understand their roles and responsibilities. Their comments included, “We have lots of training and this helps me feel confident and qualified for the role”, “I am currently studying for [a qualification in health and social care] which my employers are paying for” and “They encourage us to do as much training as we wish.”

Staff took on extra responsibilities to lead the team in different aspects of the work. For example, 1 member of staff was a ‘dignity’ champion. They described how they worked with other staff, people using the service and families to ensure best practice was followed.

The registered manager explained they were organising some extra training for staff to experience sensory deprivation and different care interventions. They felt this would help develop their understanding from the perspective of people using the service.

The provider ensured staff worked well together and had systems to communicate with each other. Staff had a handover of information each time there was a shift change. This included discussing individual people and the service. There were clear systems for organising tasks. Staff were familiar with these and took turns leading shifts to make sure they understood different responsibilities.

Staff worked well with external professionals. They made referrals to different services when they identified people had a specific need. There was evidence of regular communication with these professionals and that staff followed their guidance and direction.

The provider made sure people received the support they needed to stay healthy and well. Relatives told us they thought people received good quality care to meet health needs. Their comments included, “[Person] is in good health and staff always let me know if [they] are not well or there is an appointment” and “[Person] recovered well after [a period of ill health]. This was because staff looked after [them] so well.” Relatives also told us staff supported people to stay active and mobile, to maintain a healthy weight and to eat nutritious meals.

Staff carried out a review of people’s conditions and fitness levels. They helped to develop personalised programmes to improve fitness and mobility. A member of staff told us, “Everyone does keep fit. An instructor comes to the home and helps them. Most people go for a walk each day as well and people are working towards a healthy weight.”

Staff created health action plans which included information about people’s health conditions and how these were being monitored and met. There was close working with external healthcare professionals to make sure people received the support they needed.

Staff monitored people’s wellbeing. They monitored food and fluid intake and encouraged people to eat and drink well. Staff also monitored people’s weight, fitness levels, skin condition and how they spent their time. Each month, a key member of staff reviewed outcomes for people and used this information to plan care and support.

People were supported to learn new skills and develop independence. Staff monitored this by observing and recording how people managed with different tasks. They created personalised step by step plans for each person which reflected their achievements and the support they required.

The provider obtained consent for decisions about people’s care. People were well informed about daily choices. Staff understood how people communicated and understood information. They presented choices in a meaningful way and respected people’s decisions.

Staff assessed people’s mental capacity to make more complex decisions. When people lacked the mental capacity to understand these, the provider had consulted with their legal and family representatives to make decisions in people’s best interests.