243 Church Street

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 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 83 (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 andreviewing their health, care, wellbeing and communication needs with them.

Care plans were reviewed regularly and information about people’s needs and wishes were current. A log of previous entries in the electronic care records system showed historic records of people’s needs, allowing staff to track the development of any concern or healthcare need. This meant the provider were constantly assessing people’s needs and making adjustments to their care plans in order to give them care that met their current presentation. For example, a person’s care notes stated they were upset and appeared in pain. Staff arranged a GP appointment and medicines to assist with the pain were prescribed. This showed the provider was proactive in reviewing people’s needs and escalating these concerns when necessary.

Referrals and reports from other health professionals who were involved in a person’s care were kept on file, so that these records could be referred to by staff to inform the care of that person.

The provider ensured that trauma-informed care was provided by learning about people’s history. They did this by ensuring that a thorough assessment of each person’s needs was completed before people came to live at the service. They consulted with the person, their relatives and professionals involved in their care to build a complete picture of their care needs. Knowing about people’s lives prior to them coming to live at the provider helped staff to understand people and their preferences, as well as avoiding situations that may lead to negative experiences for people.

A relative told us, “[Person’s] care plan is updated regularly and they contact us regularly if there are any changes or new plans.”

The provider consistently planned and delivered people’s care and treatment in partnership with them, ensuring their preferences, values and what mattered most were central to all support. This was carried out in line with relevant legislation and underpinned by a clear commitment to evidence-based practice and recognised standards.

The nominated individual and registered manager demonstrated knowledge of research and theory around supporting people with a learning disability. This learning and approach were embedded in the systems which were in place for people. Policies, procedures and training referenced evidence-based support models and advised staff on how to effectively apply this approach to enrich people’s lives.

Leaders advised us they had applied a variety of research in creating the support model for the provider, drawing from different sources to create a model which was tailored to meet people’s needs. This showed leaders were knowledgeable about evidence-based care and treatment and meant they created systems which ensured this knowledge was passed on to staff and applied by them.

Leaders told us the evidence-based model they used was intended to support people to set meaningful and measurable goals to measure their progress. For example, one person can now independently had gained the ability to gather toiletries and clothing in preparation for bathing, requiring only minimal prompts. The staff supported them to do this by creating small measurable goals which built towards the end outcome they were seeking. Another person who had sensory issues relating to clothing and removed their clothes constantly, had developed the ability to tolerate wearing clothes. This allowed them to take part in social activities with the other people living at the provider and to go out on a regular basis. These examples showed the evidence-based approach taken by the provider led to positive outcomes for people.

Staff and leaders received training in positive behavioural support and talked to us about their emphasis on using alternatives to negatives such as the word, “No”. They explained the word negatives can trigger a reaction in people and lead to conflict, so using alternative responses can lead to a more positive outcome. We observed staff practicing this, For example, when a person who was being supported to make healthier food choices asked for a biscuit prior to their lunch, staff replied, “It’s nearly time for lunch, so perhaps you could have a biscuit after you have eaten your lunch.” The person was satisfied with this response. This showed staff understood their positive behaviour support (PBS) training and used communication methods which were in line with current best practice.

The provider used an electronic system for recording and monitoring people’s care. This contained nationally recognised health and social care tools to monitor people’s health and identify any concerns. For example, tools were in place where appropriate to monitor people’s nutritional and fluid intake, weight, pain levels and skin integrity. This showed the provider was using evidence-based wellbeing indicators to ensure people’s continuing health management.

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 provider actively sought and valued feedback from professionals to strengthen partnership working. This commitment to continuous improvement enabled them to refine communication and enhance collaborative outcomes. Feedback from professionals was positive. One professional fed back to the service that, “They are so friendly and kind. I was so surprised and touched by how staff interact with the housemates – it felt less like a carer–patient relationship and more like friends and family. I learned a lot from this.” Another commented, “Everything is perfect,” reflecting the consistently high standard of care and partnership working delivered.

Robust systems were in place to ensure effective communication between staff and external professionals. Visits from professionals were thoroughly documented in handover notes, ensuring continuity between shifts and prompt follow-up on actions. Guidance from professionals was not only listened to but meaningfully incorporated into care planning. For example, a person’s diabetes care plan had been developed in line with specialist advice from the hospital diabetes team, clearly outlining risks, early warning signs, and contact details to enable staff to respond swiftly and appropriately to any concerns.

Care planning was detailed and proactive, with each person benefiting from a comprehensive hospital passport. This ensured that, should a person require hospital treatment or support from another provider, essential information was immediately accessible to unfamiliar professionals, promoting safe, effective, and personalised care. Passports included key information such as medical history, prescribed medication, allergies, and individual care needs.

Staff and leaders demonstrated a proactive and preventative approach to health and wellbeing. They made timely referrals and maintained strong communication with external services to ensure people received specialist input when required. For example, appropriate referrals had been made to dietitians and Speech and Language Therapy (SALT) services to support individuals with specific dietary and communication needs, ensuring tailored and holistic care.

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.

The provider used healthcare tools which monitored key indicators such as weight, fluid and dietary intake to establish if people were losing or gaining weight at a concerning level. This allowed them to be proactive in ensuring that people were offered the opportunity to make choices to maintain their wellbeing.

A relative told us, “The staff know who likes what, as far as food is concerned. There are always freshly cooked food and fruit available.”

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

There was an exceptional amount of monitoring and recording which was analysed and used to improve the quality of care. The electronic care recording systems allowed staff to regularly record information, such as, what people had done during their day, their diet and fluid intake. In addition to monitoring basic indicators of people’s health and wellbeing, leaders completed regular audits on subjects such as dignity, dining experience, care planning and shift handovers. All this information was used to inform quality meetings, where staff and leaders identified themes and trends, taking action to improve the quality of service where necessary.

The provider regularly reviewed people’s progress and completed a report which was shared with the person’s relatives where appropriate. The reports were written in positive language and celebrated people’s achievements. For example, a person’s progress report stated “[Person] enjoyed their Christmas dinner, which was a positive milestone that they are tolerating a full meal. These moments demonstrate they are becoming more comfortable with different foods.” This example showed the provider went into detail to observe and record the progress each person had made in their lives.

In addition to recording observations and analysing data to monitor progress, people’s responses to activities were used as a measure of the success. For example, a person’s progress report stated they had enjoyed a particular activity. To evidence their enjoyment the report stated, “They were heard making their happy sounds. Their facial expression and vocalisations indicated they were relaxed and content.” This showed the provider paid attention to the person themselves, using their understanding of the person, their behaviour and communication, to monitor and improve outcomes for them.

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

Where people were unable to communicate their needs, staff were observed asking people for consent before carrying out care tasks or advising them of what they planned to do and explaining why.

A relative told us, “For [person’s] personal care, the staff sit outside the bathroom and monitor teeth cleaning and self-cleaning after the loo.” This showed staff respected people’s independence, whilst stepping in to provide support around personal care if this was required.

The provider understood their responsibilities under the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS). This legislation protects the rights of people who may not be able to make certain decision for themselves. Where necessary, the provider had applied for authorisation to deprive people of their liberty. Where people were unable to make a decision for themselves, the provider had assessed the person’s capacity and made a decision in their best interest and clearly documented this process.