A & T (Salisbury) 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 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Leaders told us they always visited a potential new person to the service to assess their needs. This ensured the service would be suitable, and able to support the person well.

People confirmed an initial assessment of their needs took place. One person said “They came out at first and asked a lot of questions. They wrote it all down and I have a typed sheet with it all on, very good”.

Although the provider effectively assessed potential new people, we found care records did not demonstrate the provider always planned and delivered people’s care and treatment with them, once they were in service. They did not always follow legislation and current evidence-based good practice and standards.

People received care in line with what mattered to them. Leaders regularly discussed people’s care with them to ensure it remained relevant and what they wanted. However, written formats such as risk assessments, care planning and daily records were not in line with best practice and did not demonstrate the depth of knowledge leaders held informally about people. The lack of recording did not enable effective monitoring and increased the risk of poor care in the absence of leaders providing people’s support.

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.

Leaders worked alongside a range of health and social care providers to ensure people received effective care. This included liaising with social workers, occupational therapists, GPs and local pharmacies as needed. People and relatives confirmed this. One relative said their family member had experienced a deterioration in their health, so leaders had arranged a review with their social worker to discuss if further support was needed.

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.

Leaders told us they encouraged people to have a well-balanced diet, and regular reviews of their health. They said they always encouraged people to eat fruit alongside a snack and have sweet treats in moderation. People confirmed this and said the reliability of the service ensured peace of mind, so they did not need to stress about anything. One relative told us their family member’s health had improved through regular food and support with medicines. Other relatives said ensuring good fluid intake and support with personal care to ensure healthy skin had helped their family member keep well.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. People were positive about the service they received and experienced good outcomes. One relative said “They are fantastic. They have been the making of [family member.]” Another relative said, “[Leaders] are friendly and make sure clients have the care they have asked for.”

Leaders regularly asked people if they were happy with their support, or if they wished any amendments to be made. One relative confirmed this and said, “They are always tweaking how they deliver their care.” Records showed people’s personal goals had been discussed, but steps to achieve them had not been identified. The goals had also not been reviewed or amended. This did not ensure a positive, proactive approach to care planning.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Leaders told us people’s consent was always gained before any care intervention. However, information about capacity and decision making were not always identified within people’s care plans.For example, a record identified a decision made by a relative which restricted their family member’s choice, without demonstrating the involvement of the person or an assessment of their capacity.

Staff told us they had not recently received training in the Mental Capacity Act and were not able to show their understanding of the subject when talking to us. Training in Mental Capacity was not included in staff training records. This did not ensure staff had the required knowledge or skills to promote effective decision making.

Leaders told us they were not sure why this was as staff had completed training. They said they would arrange refresher training to enhance knowledge.