Senad Community Ltd-Coventry

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 changed to outstanding.
 

This service scored 92 (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 health, care, wellbeing and communication needs so staff could deliver care that reflected people’s individual needs and choices. Assessments and care plans gave staff information about people’s routines, communication, risks, health conditions, sensory needs, mobility, nutrition, medicines, mental capacity and support needs.

The provider supported autistic people, people with a learning disability and people who did not communicate verbally or needed staff to understand small changes in their presentation. Staff used care plans to understand people’s body language, facial expressions, gestures, routines and individual signs of pain, anxiety or distress. This helped staff identify when people’s needs changed and respond in a way that reflected the person’s usual presentation.

Assessments included information from people, relatives and professionals. This helped staff understand people’s histories, relationships, cultural needs, protected characteristics, personal routines and what mattered to them. Care plans were reviewed monthly as a minimum, or sooner when people’s needs changed. Staff had access to current information through electronic care records, handovers, supervision and team communication.

The provider’s assessments considered peoples current needs and future goals. Staff used these assessments to support people to develop independence, access the community, manage health needs and maintain relationships with people who were important to them. Professionals told us staff knew people well and implemented advice.

Assessments were detailed, person-centred and helped staff understand people well.

The provider consistently planned and delivered care in line with legislation, current guidance and recognised good practice. Staff used specialist advice, evidence-based approaches and training to support autistic people and people with a learning disability, health and communication needs.

The provider had assessed that all care staff were required to complete learning disability and autism mandatory training at Tier 1 and Tier 2 before working shifts. This was important because staff directly supported autistic people and people with a learning disability, and Tier 2 training gave staff a more in-depth understanding of people’s communication, sensory needs, rights and lived experiences.

The provider went beyond mandatory training by reinforcing learning through additional autism and learning disability training, co-produced resources, person-specific training and reflective practice. Staff received educational resources, including videos and information co-produced by autistic people and people with a learning disability. The provider also worked with professionals, including the Community Learning Disability Team, to deliver person-specific autism training when new people started using the service. This helped staff understand people’s individual needs, triggers, communication and support strategies before providing care.

In addition, immersive learning was used to help staff understand autistic people’s sensory experiences. Staff had access to the Autism Bus Experience, which simulated sensory, communication and environmental challenges autistic people may experience. Staff then took part in structured debriefs to reflect on sensory overload, communication barriers, uncertainty, reasonable adjustments and how learning could be applied to everyday support. This helped staff move beyond basic awareness and consider how the environment, communication and staff approach could either increase or reduce people’s distress.

Learning was embedded into practice through training evaluations, supervision discussions, person-centred care plans and hospital passports. These records included information about people’s communication needs, sensory preferences, reasonable adjustments, triggers, strengths and support strategies. This helped staff and healthcare professionals understand how to support people consistently and make adjustments when people accessed care and treatment. One staff member told us, “The training helped me understand that people’s behaviour often communicated distress, anxiety, pain or unmet need, rather than being viewed as challenging behaviour.”

Staff used professional guidance to support people safely and effectively. Care records included guidance from speech and language therapists, occupational therapists, nurses, GPs, dentists and behavioural specialists. Staff followed epilepsy protocols, choking guidance, nutrition and hydration advice, moving and handling guidance, communication plans and positive behaviour support strategies.

Staff used appropriate training methods and least restrictive approaches when people became distressed. They focused on prevention, reassurance, distraction, redirection and understanding people’s early signs of distress. In one example, staff identified that a person’s distress increased when they experienced sensory discomfort and difficulty regulating their emotions. Staff updated guidance to include preventative strategies, including reducing environmental triggers, offering reassurance and giving the person time and space to regulate. This helped staff respond earlier, reduced the need for reactive intervention and supported the person in a calmer and more consistent way.

Records showed physical restraint was rarely used and only used as a last resort. This demonstrated that staff used evidence-based approaches to understand people’s distress, reduce restrictions and protect people’s rights. People benefited because staff did not rely on generic support plans or restrictive responses. They used specialist advice, lived-experience training, immersive learning and recognised good practice to provide personalised care that improved safety, emotional wellbeing and quality of life. One relative told us, “Staff are very well trained. The confidence they have in taking my relative out in the community and never having to physically restrain them is just fantastic. I could not do it.”

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. Professionals gave very positive feedback about partnership working. They said staff understood people well, listened to advice and implemented recommendations. One professional told us, “The provider always came with solutions and worked constructively with us.” Another professional said, “Staff are patient, knowledgeable and reliable when supporting people with complex needs.”

Staff worked closely with social workers, commissioners, housing providers, community learning disability teams, mental health teams, hospitals, GPs, pharmacies, dentists, speech and language therapists, behavioural specialists and families. This helped people access services, plan transitions, review risks and respond to changing needs. Staff had access to information through electronic care records, handovers, emails, supervision and team meetings, which helped them understand and follow professional recommendations.

The provider supported one person with high support needs by maintaining regular contact throughout their admission, attended meetings, worked with a multidisciplinary team and contributed to discharge planning. Staff then supported the person and their family over time to prepare for independent living. The person later moved into their own home and began developing greater independence while maintaining important family relationships.

The provider also acted promptly when professionals raised concerns. When an advocate raised concerns about delays linked to a behavioural clinic referral, the provider followed this up, found out why there was a delay and found a positive resolution. The complaint was closed after the referral was completed. This showed the provider worked openly with partners and acted when coordination needed to improve.

The provider consistently supported people to manage their health and wellbeing, maximise their independence, choice and control. Staff knew people well, recognised changes in their health and advocated for medical input when needed.

Staff supported people who had a wide range of health needs, including epilepsy, diabetes, cardiac risks, nutrition, dysphagia, mobility, oral health, mental health and emotional wellbeing, exceptionally well. Where required, staff monitored changes in people’s presentation, appetite, weight, mobility, mood, communication and behaviour. This was important because some people could not verbally describe pain, illness or discomfort.

The service supported people to understand and implement healthier living in a variety of ways. Staff supported a person who experienced significant anxiety about their health following serious cardiac incidents. Staff recognised when the person’s symptoms were consistent with cardiac concerns and escalated for medical assessment where appropriate. This led to the person receiving timely hospital treatment for serious cardiac issues which prevented further harm. Staff continued to provide reassurance, emotional support and education so the person could understand ways they could maintain their health and wellbeing. The person reported feeling “safer” because staff listened to their concerns and acted on them.

Staff also supported people to improve long-term health outcomes. One person had previously required dental treatment under general anaesthetic or sedation because of high anxiety. Staff worked closely with the person to help them to understand the processes involved and with dental professionals and used a gradual, person-centred approach to reduce the person’s anxiety. This included preparing the person for appointments, using reassurance, going at the person’s pace and helping them become more familiar with the dental environment and treatment process. The person later completed dental treatment without general anaesthetic. This improved their oral health, reduced the risks associated with sedation and increased their confidence to access dental care in the future.

Staff promoted healthier lifestyles through education and support with healthy meal options, hydration, exercise, community access and health appointments. Relatives told us staff supported people to attend appointments, kept them informed and escalated concerns promptly. One professional told us, “Staff are on top of urgent health issues, which no doubt keeps people safe and healthier for much longer.” This showed staff actively promoted people’s physical and emotional wellbeing and helped prevent avoidable deterioration.

The provider monitored people’s care and treatment to continuously improve it. Where possible, staff ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider used care planning, daily records and quality checks to monitor whether support was improving people’s lives. Care plans were reviewed regularly and updated when people’s needs changed. Staff recorded daily outcomes, incidents, health concerns, appointments, activities and changes in presentation. Leaders used audits, file reviews, spot checks, supervision and team discussions to identify patterns and check whether support strategies were effective. This meant staff could adapt support quickly when people’s communication, health, behaviour or emotional wellbeing changed.

The provider used outcome-focused support to help people gain independence and reduce reliance on services where possible. One person had previously experienced difficulties with medicines, stoma care, wound care, hygiene, appointments, hoarding, tenancy risks and social isolation. Support from a previous service had not worked well because the person felt controlled. Staff at Senad Community changed the approach by building trust, listening to the person and communicating in the way the person preferred. Staff worked with professionals and supported the person to re-engage with health appointments, medicines, personal care, their home environment and community life. The person’s confidence, independence and engagement with health and daily routines improved, so their support was gradually reduced to drop-in visits and later ended. This showed staff had helped the person regain control, maintain their wellbeing and manage their daily life more independently.

People achieved further meaningful outcomes. Staff supported people to develop daily living skills, improve communication, access new community activities, attend health appointments and become more confident with familiar support. One relative told us, “Staff know my family member as much as me, if not better.” The relative described improvements in their family member brushing their teeth, eating independently, taking their bowl to the sink and tolerating nail care.

Feedback from relatives, staff and professionals was used to identify what worked well and what needed to improve. This showed the provider did not simply monitor care records. Leaders used information about people’s progress, experiences and outcomes to adapt support and help people achieve meaningful improvements over time.

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

Staff used people’s preferred communication methods to seek consent before providing care and support. They used speech, gestures, facial expressions, body language, pictures, objects of reference, Makaton and familiar routines to understand whether people agreed, refused or needed more time. This was important because many people did not communicate verbally and needed familiar staff, reassurance and time to understand information and express their choices. One staff member told us, “We look for facial expressions, body language and any signs that someone is not comfortable before providing support.”

Records showed MCA assessments and best-interest decisions were consistently in place where people lacked capacity to make specific decisions. These covered areas such as care, health, medicines, community access, restrictions and support arrangements. People’s views, wishes and known preferences were included in decisions. Relatives, advocates and professionals were involved where appropriate, which helped make sure decisions reflected the person’s rights and best interests.

People lived in supported living settings. Records showed Court of Protection authorisations were in place where support arrangements amounted to a deprivation of liberty. Restrictions were reviewed to make sure they remained necessary, proportionate and least restrictive.

Staff supported people to make everyday choices, including what to eat, where to go, what activities to do, who supported them and whether they wanted personal care or assistance. One person told us staff listened to them, asked before helping and respected when they said no. Where people made choices that involved risk, staff balanced consent, capacity and safety rather than automatically restricting people.

This showed the provider protected people’s rights and promoted lawful, person-centred decision-making.