Durlston House

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.

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 had lived at the service for a long time, with the last person moving in 10 years ago. The manager told us no-one was currently looking to move out of the service. The provider had a team available to help with assessments of people’s needs as well as supporting people to move into a service. The manager said this would involve close working with people’s existing care provider.

People’s needs had been assessed and were regularly reviewed, to ensure records reflected people’s current needs. Staff worked with people’s social workers to complete care reviews. Assessments were used to support people to plan how their needs should be met.

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. Staff had completed nationally recognised specialist training for people with a learning disability and autistic people. Staff were positive about their training and felt it enabled them to better meet people’s needs. The service had information about people’s specific health conditions from specialist nurses and used these when planning people’s support. This helped to ensure care was planned in line with current best practice guidance.

The manager told us they had access to good practice information through the provider’s website, including updates on changes in legislation. The manager said they had focused on implementing guidance to reduce restrictions for people, which had resulted in increases to people’s quality of life.

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 told us there was good communication amongst the team and we observed staff working together to meet people’s needs. Examples included work with speech and language therapists to support people to develop their communication methods and work with the epilepsy nurse which had led to a reduction in seizures a person experienced. We also saw work with the rheumatology team to effectively support a person to manage changes to their medicines.

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 demonstrated a good understanding of people’s health needs and said they had the guidance they needed to provide effective support. Information about people’s health needs was reflected in their support plans. One person’s plan set out how to support them effectively to attend dental appointments, which had been developed in conjunction with the learning disability behavioural team. This resulted in a person being able to attend dental appointments, which they had historically found difficult.

Relatives told us and people’s care records demonstrated they had been supported to access relevant health services, including GP and specialist nurses.

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.

Staff maintained records of the care they had provided and observations of people, for example, people’s seizures or details of anxiety and distressed reactions. Records demonstrated changes were shared with health and social care professionals where needed.

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

At the last inspection we found decisions about restrictions on people had not always been made following the best interest decision making process. At this inspection we found this had improved. Staff demonstrated a good understanding of the Mental Capacity Act and consent. Staff understood the need to follow the best interest decision making process if people lacked capacity to consent to a specific decision. Since the last inspection the management team had reviewed restrictions and had reduced them where possible. Records demonstrated decisions had been made following consultation with people, their relatives, social workers and formal representatives.

During the inspection we observed staff gaining people’s consent before providing any support and when planning what people wanted to do.