Dolphin Homes Ltd Supported Living Services Office

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 requires improvement. At this assessment, the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The service was in breach of legal regulation in relation to person centred care.

This service scored 67 (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 did not always make sure people’s care and treatment were effective. They did not always ensure when people’s needs changed guidance was up to date and their changing needs were understood and supported by all staff.

For 1 person who had a medical condition, their care plan did not detail how they may present when having a seizure, this meant there was a risk staff may miss the seizure. One person required an hourly check during the night due to a medical condition. We reviewed records of these checks and noted they ranged from 30 minutes and 2 hours between checks. For another person, on 4 separate documents there was conflicting information about how regularly their blood sugar levels should be monitored. We spoke with the provider about this who told us these documents would be updated.

Staff told us people’s views were sought by using their preferred communication methods across various platforms including, during daily support and in meetings with their keyworker.

People were involved in their assessments and reviews. Staff and/or those who knew people well were involved in people’s assessments to ensure their views and opinions were captured.

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 used nationally recognised tools appropriately to assess and monitor people’s needs. For example, Recognise Early Soft signs, Take Observations, Respond and Escalate (RESTORE) to identify when people’s health was deteriorating and the Malnutrition Universal Screening Tool (MUST) was used to identify people at risk of malnutrition.

People were supported to maintain relationships with friends and family through physical visits and by making phone and video calls.

The service worked well across teams and services to support people. The staff team worked together with a variety of health and social care professionals to ensure care and support was received when required. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People’s goals, dreams and aspirations were discussed in keyworker meetings and always communicated so a consistent approach was maintained between services. The registered manager gave us examples of how they wanted to further develop and improve this.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service did not always support people to live healthier lives and where possible, reduce their future needs for care and support.

Care records captured the support people required with their health needs and what action staff should take when there was any deterioration to an individual’s health.

People were supported by a staff team who knew them well and who were able to detect signs of a person being in distress or their health deteriorating. Where needed people were supported to access emergency healthcare.

However, people were not always offered meaningful activities or supported to eat healthily, and these needs had not been comprehensively assessed and planned for. During the inspection the registered manager started taking action to address these shortfalls.

The service did not always effectively monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People were engaged to ensure they were able to make some choices about their lives. Individual meetings took place with people to understand their goals and aspirations. However, these had not been effective in improving people’s healthy eating and activities to ensure people had positive health and wellbeing outcomes.

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

Where necessary, mental capacity assessments were mostly completed in line with the Mental Capacity Act 2005 (MCA) and Best Interest (BI) meetings were held, following mental capacity assessments. Some BI meetings required more detail relating to relatives input and views.

We reviewed documents and observed staff gained people’s consent. Staff told us they always sought consent from people and explained what they needed to do to support the individual safely.

A DoLS tracker was in place to ensure the provider knew when these needed to be reapplied for. Staff described how they sought consent throughout the day-to-day tasks they supported people with.