ECHO Supported Living Services Limited

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 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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and Communication needs with them. The assessment process was exceptional. Everyone had a detailed and bespoke referral into the service which covered all aspects of the persons life including diagnosis, health needs, communication and current challenges. The assessment process considered detailed information about environmental needs, staff training requirements and identification of a MDT to support admissions. We saw examples of how this approach enabled early identification of steps the provider could take to improve people’s outcomes. For example, a person had previously experienced multiple placement breakdowns, the assessment identified this and how this could be avoided and led to a successful transition. A bespoke transition plan was put in place which used the previously identified MDT approach and was timed to meet specific and individual needs. The registered manager told us they had an assessment process in place which engaged people, families and other professionals in undertaking the assessment and forming the care plan. Relatives consistently told us the assessment process was really successful with staff taking into account past experiences, what worked well and not so well. Relatives were without exception involved in the assessment process and could share their successful admission experience. A relative told us, "[Person’s name] is better in their own space than previous residential setting, their staff are focussed on them. The strategies they used on admission are still working now." Partners were extremely complimentary about the service and its partnership approach to assessment. A partner told us, "Both the management team and staff are aware of when there is a need to involve outside agencies." Staff were extremely knowledgeable about people’s assessments and care plans and told us they used these to guide the support people received. The provider fully engaged staff in developing assessments and care plans. A staff member told us, “They are continually updated and the records are all accessible to us, we also are involved in sharing information for updates, reflective practice is used to guide how the support plans are updated.” We saw assessments and care plans were consistently detailed, and individualised which led to a robust process which was valued by all those involved. The assessment process had led to multiple successful transitions into the service enabling people to have their own home in the community, often for the first time and exceeding many of the expectations of the placement.

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. The registered manager told us they used a series of evidence-based tools to support with the delivery of people’s care. We saw people had hospital and communication passports in place. Positive behaviour support plans were in place for people, and everyone had a health action plan in place. We saw staff used these tools to ensure people had the right support. Relatives were aware of the different tools which were in use and told us they were effective. A relative told us, “[Person’s name] has a communication passport, it is reviewed regularly and used, staff have picked it up really well and there are pictures around the house for staff to use.”

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 ensured people had a core team in place to support them. Staff were recruited specifically to support named individuals. Staff told us they were fully involved in sharing information and giving updates on peoples care and their outcomes. They described how they used reflective practice as a tool to assist in updating support plans. The registered manager told us they had a system in place for staff to share information about people at the start and end of their shift and described using email and other communication channels to ensure staff stayed up to date on peoples care plans.

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. People told us the staff supported them to attend health appointments. Relatives told us staff understood people’s health needs and ensured they received appropriate support. A relative said, “The staff do understand his health needs, they do understand them as a person. They are really well looked after, the consultant involved is happy and sees them regularly.” Staff told us they understood people’s individual health conditions and had information in peoples care plans to guide how people were supported. Staff could describe in detail people’s history and their individual health needs. We saw care plans gave details about people’s individual health needs. The registered manager told us there was a health action plan tracker in place to monitor the outcomes of all health appointments. Partners told us the provider had a good knowledge of identifying when specialist input was required to support people.

The provider 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.Relatives all felt people’s health and wellbeing had improved over time since using the service. Everyone we spoke with without exception could share examples of how people were meeting and often exceeding their expected outcomes since using the service. A relative told us, “[Person’s name] anxiety is reduced, and they are experiencing less behaviours and self-harm. We feel [person’s name] health and well-being have improved no end.” Another relative told us, “What has changed for the good is [person’s name] has had their staffing reduced at night, with back up in place in case it is needed. This is positive, it’s less restrictive, any issues it can go back to how it was.”Complimented were continually received about the service from a range of different stakeholders, these included comments about exceeding expectations. The comments were wide ranging, for example, mentioning successful anxiety reduction, support in hospital admissions leading to a good health outcome, transitions into the service, reductions in restrictions and much more. A social worker had commented, “This has been the smoothest transition I have experienced in my years of commissioning.” Staff were proud of people’s achievements and could easily describe how people had improved their quality of life over time, describing improved communication abilities, decreases in anxiety, ability to access the community and forming relationships. The registered manager told us evidencing outcomes for individuals was a strength. We found the provider used multiple monitoring tools to support progression measure and track outcomes, and support improvements in overall quality of life. Quarterly reports were used to review these tools and chart progress. The reports reviewed all aspects of peoples care and highlighted progress against their goals. For example, 1 person’s report showed a decrease in anxiety had led to a person being able to spend more quality time with a family member. Another person’s report showed a successful transition into a placement with the provider, following multiple previous placement breakdowns. We saw people had achieved an improved quality of life. For example, improved health through engagement with health services enabling early diagnosis of physical health conditions. Increased choice and control leading to a decrease in anxiety and associated incidents. The ethos and focus of the service was on continual improvement and increasing people’s quality of life.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People had their capacity assessed and decisions were taken in their best interests. Relatives were aware of the processes in place to keep people safe and enable decisions to be made. A relative told us, “[Person’s name] is safe, they have 24-hour [care] and a Deprivation of Liberty Safeguards (DoLS) in place, so the doors are locked, we have no concerns about this.” Another relative told us, “[Person’s name] rights are protected, they seem aware of the mental capacity act and assume capacity but also keep them safe.” The registered manager told us some people using the service had a community-appointed DoLS in place. This is a legal process that allows for the lawful deprivation of liberty in a community setting, when necessary, care and treatment cannot be provided in a less restrictive manner. There was a tracker in place to monitor when these needed to be renewed, and the provider had systems in place to request these were done. The registered manager told us there were systems in place to ensure any conditions were included in peoples support plans. Documents we saw supported what we were told. Staff understood how to seek consent from people and could tell us where people could make their own decisions what support they gave.