Selective Care

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 inspection this key question was rated good. At this assessment the rating remains 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 provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People told us they participated in planning their care and were consulted about developing their care plans. They told us they had received copies of their care plans and were happy that they reflected their needs.

The provider conducted an initial assessment of people’s needs and at appropriate intervals thereafter. Senior staff completed the initial care visits when care packages commenced or restarted after hospital discharge. The registered manager told us that this helped them understand people’s needs, develop care plans and support staff.

The provider planned and delivered people’s care and treatment with them. They did this in line with legislation and current evidence-based good practice and standards.

People were happy with the support they received around eating and drinking. They told us that staff helped them prepare meals and drinks in line with their needs and preferences, which helped them to eat and drink well.

The provider’s policies and procedures were developed in line with best practice guidance. They had used an external company to help develop policies and had adapted them to make them relevant to the service. Nutrition and hydration needs were assessed and documented in people’s care plans. Where people required a modified diet, staff had received additional training to help ensure they understood how to prepare food and drink to specified textures. This helped ensure food and drink was prepared as recommended.

The registered manager had qualifications to teach staff behavioural support techniques, such as positive behaviour support. This is where staff try to create positive conditions to minimise anxiety or distress. People’s care plans reflected the principles of positive behaviour support and staff told us how they adopted these strategies in their everyday support to people. This helped to promote positive outcomes, especially in the levels of engagement for people who may be reluctant to receive care.

The provider had formed effective relationships with stakeholders, such as commissioners, social workers and health professionals. We received positive feedback from 2 professionals around how the provider had made improvements to care planning in line with their recommendations, which helped to improve the quality of care. They told us the registered manager was collaborative and responsive, which helped to promote effective working relationships.

People’s care plans detailed where other stakeholders had input into their care. The provider reported concerns to health professionals and incorporated their recommendations into people’s care plans. One relative told us, “The company organised the occupational therapists to get equipment when he had been having falls and altered the care plan, so he had 2 carers at each call.”

The provider had developed effective working relationships and information sharing agreements with other providers, where they shared care responsibilities. This included sharing care plans, evacuation procedures and communication between respective staff teams. This helped to ensure there was a joined up and coordinated approach to delivering care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

People told us that staff had a good understanding of their health needs and medical conditions. They told us that staff provided effective support to promote their health, which included support to attend appointments.

People’s care plans detailed the support they needed to meet their healthcare needs. They included information about how health and medical conditions affected their everyday life and how staff could support them to overcome the challenges they faced. For example, for how people presented on ‘a good day’ and on ‘a bad day.’ This helped staff adapt their approach and levels of care according to these circumstances.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

People told us they had positive outcomes in relation to the care they received. Relatives told us that staff were pro-active in communicating updates and changes in people’s health and wellbeing. This helped to promote positive working relationships.

People’s care plans documented the key care tasks related to meeting people’s needs. People told us that staff were clear about the care tasks that were required. This helped to ensure care was focussed on the areas where people required assistance.

Senior staff monitored that key care tasks had been completed via the electronic care planning system. The electronic care planning system was monitored both inside and outside of office hours to help ensure effective oversight of care. People and where appropriate relatives had access to the electronic care planning system. This meant they could review care notes be involved in monitoring outcomes of care.

Staff told us they had all the required information about people’s care needs available to them. This helped ensure people received the care they needed. The registered manager had conducted training with staff to improve the quality and clarity of their care notes. This helped senior staff improve monitoring and determine how outcomes of care were being met.

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

People told us that staff always sought their consent to care. This included when staff were offering support around individual tasks or personal care. They said they had signed their care plans and agreed to the content.

The provider had developed effective policies around obtaining consent, which had been developed in line with The Mental Capacity Act (2005) MCA. Senior staff had a good understanding of how to apply the MCA to their everyday practice. This included detailing the actions if a person lacked the capacity to make decisions about their care. Where people had legally appointed representatives, the provider reviewed evidence to verify the scope and validity these powers. This helped to ensure only those legally appointment could act on people’s behalf. Staff had a good understanding of the need to gain consent to care. They told us they always asked for people’s consent before each care task and respected their right to decline care.