Tigh Grianan

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 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People’s care and support needs were assessed before they moved into the service.

Peoples’ care plans had detailed information, including assessment of risks. Healthcare professional assessments and recommendations were incorporated, meaning staff were supporting people’s wellbeing.

Records showed that there were regular reviews, and that plans and risk assessments were updated as a result. This included reviews by health partners, for example, speech and language therapy, neurology, psychology and psychiatry. A relative told us, “I am fully involved [in reviewing their family member’s care]. They give me the information I need. They involve me in everything.”

The home had well developed communication strategies that were based on individual needs.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff knew how to support people, and this was based on assessment by appropriate professionals, who used evidence-based practice. For example, a member of the provider’s multidisciplinary team had used tools to assess people’s sensory needs and had written support guidance for individuals based on this. All people had person centred plans that identified what things mattered to them and set objectives so they could achieve them. They also had plans that were based on an evidence-based psychology model that supports and develops well-being, relationships, and activity levels.

The provider trained all staff in techniques to keep themselves and others safe when people had behaviours that might be a risk, and this training was accredited under a recognised best practice provider.

The service 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.

There were written handover notes and verbal handovers were observed. The ‘champion’ roles enabled information and good practice to be shared across the staff team, As well as the manager there were also senior staff. Each person had a keyworker, and they held update meetings with the person weekly. Keyworker feedback was evident in team meetings.

The home worked well with professional partners, including health partners. This meant that people’s information was shared as appropriate. A health professional told us, “The team are always very engaged during the patient's follow up appointments, they implement changes advised to medication, they feedback concerns and will get in touch if they have concerns about the patient.”

All people had a health passport. A health passport is recommended by the NHS for all people with a learning disability and/or autism. It is a written summary of health needs, communication needs, and reasonable adjustment requirements that a person gives to health and social care professionals, for example in the event of a hospital admission.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

People’s care plans contained information on supporting hydration, constipation support, weight and epilepsy,. mobility, weight, skin care, oral hygiene, and continence support. People’s food choices were noted, and the home recognised the importance of exercise. Care plans included information on promoting people’s wellbeing and developing their self-worth.

The home had an oral healthcare ‘champion’. This meant that best practice and information was shared across the team.

The service monitored all 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.

The support from staff had a measurable and significant impact on people and those important to them, helping to change the course of people’s lives. The provider had its own team of specialists that had worked with the home to review and monitor support provided to people. A positive approach had been taken to risk and how this was managed, based on continuous learning. This approach was based on evidence and consistent implementation by the team. A relative told us, “It’s like winning the lottery, He was previously having 5 to 1 support, then 4 to 1, then 3 to 1, now he has 1 to 1 support or 2 to 1 support. They’ve turned around his support and wellbeing. I get emotional how they do it as I couldn’t do it myself.” Another told us, “I’m very pleased with the way things have worked out with Tigh Grianian.”

Staff told us that reviews were held and care plans were regularly updated. Information was collected daily and checked for accuracy. A staff member told us, “We review our daily notes to make sure they are accurate. It is checked [by colleagues] that we have not missed anything,.” We saw that when information was received from health professionals, care plans were updated to include this information.

Consent to care and treatment

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

Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA). A member of staff told us, “It protects vulnerable people's rights, and we should assume that people have capacity. We provide information in a way people understand to help them make choices. People have the right to make decisions we may not agree with if they have a capacity. If we need to make a decision on their behalf, it is in their best interest.”

A clear process was in place to carry out mental capacity assessments when required. When people were questioned about their capacity, this was done where a particular choice or decision needed to be taken. Staff used people’s preferred communication methods. Decisions taken about people’s capacity were reviewed every year.

People were encouraged to make choices using personal communication methods, such as pictures or objects. Staff understood people’s non-verbal ways of confirming a choice, such as the use of gestures and eye contact.