Shared Lives and Reablement Scheme

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.

This is the first assessment for this assessment service group under this location. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Some needs had not been assessed and therefore not documented within care and support documentation. For example, people’s social, cultural and religious needs had not been assessed.

The registered manager explained how they liaised with the hospital team to decide whether they could meet the person’s needs. People’s needs were regularly reviewed to see if they remained suitable under the reablement service. This was discussed in a multi-disciplinary team [MDT] meeting which included a range of relevant teams such as a social worker and physiotherapist. We observed one of these meetings during our site visit.

The provider 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.

People told us staff supported them in line with their wishes. The registered manager told us they were signed up to receive any CQC updates. The registered manager had regular management meetings and kept up to date with best practice guidelines and legislation. The registered manager commented, “I have a particular interest in self-neglect, we’re noticing this more locally.” The registered manager had undertaken some research in this area which informed the care and support offered.

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.

Staff worked well together and with other healthcare professionals. One staff member commented, “We are guided by [therapy team]. This helps us to understand [people] and their needs specific to them. We also work with district nurses.”

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 worked well with other teams to reduce future need for support. The registered manager told us, “Our goal is to promote independence. Seventy percent of people who use our service come away with less care needs from when they started with us.”

Care plans lacked some information regarding how people’s medical conditions affected them. This meant staff may not know how to support people effectively with any health conditions. We raised this with the registered manager for them to address.

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’s outcomes were routinely monitored through MDT meetings. The registered manager told us how they had linked up with other services to promote good outcomes for people. For example, they liaised with a Live Well service [health and wellbeing programme] to support one person who required some support emotionally. This achieved a positive outcome for the person both physically and emotionally.

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

Consent forms were not routinely used within care planning documentation. However, people’s consent was sought and recorded following risk assessments. People told us they were happy with the care and support provided.