Active Support Service Ltd

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 63 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People and their relatives told us they were supported to be involved in the assessment process and felt staff tailored care to meet their individual needs. They gave examples of how staff adapted their approach to ensure people were comfortable and engaged. For instance, one person enjoyed interacting with staff using their favourite toys, and staff incorporated this into their daily support to help build trust and understanding.

However, the written care plans did not always reflect this personalised knowledge or the approaches staff used in practice. More detail was required to ensure care plans were fully person-centred and accurately described how people preferred to be supported. One staff member told us, “No, I do not feel (care plans) are sufficient to provide truly person-centred care. Getting to know the customer, truly helps me in my job to provide person-centred care.” The lack of specific, individualised information meant the provider could not consistently demonstrate that people’s needs had been thoroughly assessed or that staff had clear written guidance on how to deliver care in a way that mattered most to them.

The provider did not always plan or deliver people’s care and treatment in line with nationally recognised evidence based tools or best practice guidance. For example, staff did not use standardised assessment tools such as the Waterlow pressure ulcer risk assessment or the MUST malnutrition risk assessment when evaluating people’s needs. The absence of these recognised tools meant the provider did not have a consistent or structured approach to identifying and monitoring risks related to skin integrity or nutrition.

However, we did not see any evidence that people had been harmed because of these omissions, or that risks were not being managed in day-to-day practice. Staff demonstrated a good understanding of people’s health needs and were able to describe how they monitored changes or concerns. People and their relatives also told us they felt their care needs were met and that staff responded appropriately if they noticed a person becoming unwell.

Despite this, without the use of recognised assessment tools, the provider could not fully evidence that decisions were informed by best practice or that all risks were consistently identified and reviewed. This limited the assurance that care and treatment were being delivered in a fully evidence based and systematic way.

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. The service had a small and consistent staff team, which meant people were supported by staff who knew them well and were familiar with their individual needs. This continuity helped ensure that information about people’s care was shared effectively and support was delivered in a coordinated way. One relative said, “The team is brilliant. [Relatives] couldn’t work without them. They are the best company we’ve had.” People’s relatives told us that healthcare professionals were involved in care planning and review processes when appropriate, and that staff engaged well with medical professionals to ensure people received the right support at the right time. The management team also provided direct support to people, which helped them maintain a strong understanding of how care was delivered in practice and enabled them to observe staff interactions to identify any areas for improvement.

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. Staff supported people to manage their health and wellbeing in ways that promoted independence, choice and positive daily routines. We saw evidence that people were encouraged to drink plenty of fluids and make healthy food choices, and staff used everyday opportunities to reinforce healthy habits. People and their relatives told us staff were attentive to their wellbeing and offered guidance and encouragement that helped people maintain good health.

The provider routinely monitored people’s care and support to ensure outcomes remained positive and aligned with people’s wishes. We saw evidence that regular reviews were carried out, including checks to confirm that people continued to consent to their care plans. These reviews helped ensure care remained appropriate, up to date and responsive to any changes in people’s needs. Staff and relatives told us they felt people’s care was monitored effectively, and this contributed to consistent, positive outcomes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

There were no concerns about consent for most people using the service. Staff explained how they sought consent in day-to-day practice, and people and their relatives told us they were involved in discussions about care and support. However, where there was reason to believe that people may lack the mental capacity to consent to specific decisions, the provider did not always follow the requirements of the Mental Capacity Act 2005. We saw examples where relatives who did not hold lasting power of attorney had been asked to sign consent forms on behalf of the person receiving care. Although discussions with staff and relatives showed that decisions were being made appropriately in practice, this was not reflected in the documentation. Records did not consistently include decision specific capacity assessments or demonstrate that best interest decisions involved the right people. This lack of accurate and legally compliant documentation reduced the provider’s ability to evidence that people’s rights were upheld.