My Pillar Limited

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• 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 did not consistently ensure people’s care and treatment were assessed and reviewed. The provider reviewed care plans and assessments annually, this meant some risk assessments and care plans in the system required improvement. For example, one person had a diabetes care plan in place, but this lacked detail to explain how staff should support the person to manage their condition. However, we found people were involved in their needs assessment and developing a care plan to meet those needs. A relative told us, “The registered manager came to see [person’s name] so we could discuss their needs. The plan was written there and then, and a copy is in the house.” Staff told us the electronic record systems gave them information about people and their needs, and they also used this to document peoples care delivery. They told us any changes were updated immediately, and they were informed. The registered manager told us they used the information shared with them by people, families and social workers commissioning the care to support their assessment and the creation of a care plan.

The provider planned and delivered people’s care and treatment with them, in line with legislation and current evidence-based good practice and standards. People were supported to maintain a healthy diet. A person said, “The staff prepare my meals from scratch I don’t have ready meals as I am Diabetic. The staff always ensure I drink plenty of water especially in the hot weather, so I remain hydrated.” The registered manager told us the electronic system had a variety of tools in place to support planning and delivering peoples’ care. We saw the system used risk assessment tools for skin integrity and nutrition and hydration which were considered best practice to assess people’s needs. Staff were able to describe how they used these assessments to guide the care people received. For example, staff could describe how they used a positive behaviour support plan to support one person when they were feeling distressed and anxious and how following this helped to calm the person.

The provider had systems to ensure staff worked as a team to support people. The provider worked with people, relatives and other professionals to assess people’s needs and provide their support. The provider worked with people and other professionals to provide people’s care. A relative told us, “The staff are working with [person’s name] Social Worker, and they tell us if there has been any changes or issues we should know about.” The registered manager told us there were systems in place to ensure staff worked well together and shared information about people in the electronic care record. The staff can access the system and read about what has happened with the person ahead of the call and stay up to date on any changes. Staff confirmed they felt the system worked well to enable them to provide continuity of care to people.

People received support to maintain their health and wellbeing and access healthcare when they needed to. A person told us, “My doctor’s surgery is right behind my home and with staff I can get there in my wheelchair.” A relative told us, “The staff have been well trained in Epilepsy and handle [person’s name] seizures well.” Staff could describe how they supported people to maintain their health and told us there was guidance on how to do this in people’s care plans. A staff member told us, “[|Person’s name] has a barrier cream twice daily after personal care to protect their skin integrity.” Staff told us they would share any updates following health professional visits with the office so assessments and care plans could be reviewed and updated as needed. Records showed information about people’s health needs was included in assessments and care plans and when things changed these were updated. The registered manager told us the electronic records system has details of all health professionals included and if there are any changes we document in the system.

The provider did not consistently monitor people’s care and treatment to continuously improve it. The registered manager told us risk assessments and care plans were reviewed annually. We found some risk assessments and care plans were not linked which meant guidance may be confusing for staff. This did not impact on people’s care as staff were made aware when peoples need changed of how to support people. Staff confirmed they were kept up to date about people’s needs and could share examples of how people’s wellbeing had improved. A staff member told us, “[Person’s name] has really improved over time, they are settled and have good relationships with us, distressed behaviours have now reduced, and they are able to communicate with us better.” People were supported to improve their health and wellbeing by the service. Feedback from people and relatives showed the staff worked with people to continually monitor and improve their care. A relative told us how the provider worked with them to personalise a service users care plan in order to meet their needs as they were new to the service. Another relative told us how staff supporting with personal care had improved things for their relative.

The provider had systems in place to protect people’s rights and seek consent.The registered manager told us they sought verbal consent to people’s care plans and sharing information however there was no written record of consent signed by people. The registered manager explained the introduction of the new electronic system was not yet fully embedded and they had not implemented a system to get signed consent. This meant there was no record of people giving their verbal consent to care. The registered manager told us they would implement a form for people to sign which could be kept as a record. People had their consent sought before staff supported them. A person told us, “The staff do ask for my consent. If I have to say no, I always tell them why. There is always a choice, and they do as I ask.” Staff understood how to protect people’s rights and had received training in the Mental Capacity Act. There were systems in place to assess people’s capacity and take decisions in their best interests if needed.