Imola

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 changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services.

This service scored 88 (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 communication plans in place which included ‘How I communicate with you’ and ‘How I need you to communicate with me’. These were detailed and enabled positive interaction with people. Communication tools were always tailored to the individual and available to them to enable them to express their views, wishes and to make decisions. All staff carried a ‘bum bag’ holding various pictures for quick access to enable a person to express how they were feeling, for example, hunger, thirst, anxiety, sadness, tired, excited, angry, happy etc.

A multidisciplinary approach was taken to address all aspects of the person’s wellbeing, from physical health to their emotional and sensory needs. Meaningful support plans were developed and focused on what was important to them. They held detail on their goals and the nature and level of support they needed to achieve more independence in their daily lives and turn their wishes into realistic, achievable goals that resulted in positive changes in their life. These ranged from making a cup of tea with support to planning for and going on a holiday of their choice. People and those involved in their care took part in assessments and reviews. Plans were reviewed regularly and revised according to any change in needs. Staff understood people’s needs and how to meet them for the best possible outcomes. A staff member commented in a person’s ‘This is Me’ document, ‘[Name] has allowed me to truly engage into his world of sensory needs and enjoyment. His smile resonates more often than not over recent times, which includes a lovely place to be for [Name]. His ability to communicate through his signs and sounds gives me great indication of his requirements and needs. [Name] is an amazing person and once he lets you into his world it’s a truly remarkable place to be.’

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 provider had an in-house team that included a PBS team and clinical psychologist to ensure care, treatment and support reflected best practice guidance. This included a person-centred approach and active support. Specifically designed daily activity plans were in place for people that provided the right sensory opportunities and adaptations throughout the day to help improve their wellbeing and quality of life. For example, engaging in activities that kept people’s hands busy and provided sensory input to help to reduce anxiety and distract from PICA. One person had sensory needs in relation to texture and taste of food; they ate only one type of processed food for breakfast, lunch and dinner. The staff worked well with this person to introduce a healthier balanced diet with similar texture and taste. Staff told us that the person now ate a more varied range of food.

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. Everyone had an ‘All About Me’ document which clearly provided relevant and important information about their likes, dislikes, what they need help with, how they communicated including triggers, early signs of agitation and increasing signs of agitation, a sensory profile, health needs and prescribed medication. This document together with their positive behaviour support plan helped people to tell their story and have their needs met safely and consistently when they moved between services. A professional told us that all documentation was made available to them during visits, information provided to staff was always followed up and staff were always available to discuss people’s care. They told us the service had proactive practices to safeguard people and ensured appropriate services were always involved where needed.

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 had access to external health and social care professionals when they needed them. Staff and leaders supported referrals, and whilst they were waiting for them, they worked with people to ensure their needs were met and utilised best practice resources. People attended external appointments with reasonable adjustments considered, planned for and communicated. This meant people had a positive experience, good outcomes and their disability did not prevent them from accessing prompt care and treatment.

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. There was clear evidence the service had achieved significant reductions in crisis situations and the use of restrictive interventions with improved outcomes for people. For example, following admission one person’s behaviour escalated to damaging property. This was initially attributed to their move into adult care but continued to increase in frequency and severity. A skilled sensory and functional assessment and collection of data was carried out and found the person had complex multi-sensory processing needs which were not being met. A sensory action plan was developed using the findings from the assessment. This informed the development of a sensory action plan. The plan involved the collection of large water cooler bottles from head office to take back to Imola and fill with scrap items the person found around the house, helping to keep the house tidy. This engaged them and gave them a sense of responsibility as it is a PICA friendly home. The bottles were seen in their room. They had their own ID badge created by the providers HR (human resource) team which says, ‘Good Job Man’. They were very proud of the badge and wore it going about their work taking care of the environment. Incidents of property damage had decreased significantly and remained low, and their consistent sensory support strategy had led to an increase in their quality of life. People were actively supported and empowered to develop new skills. Staff introduced new ideas to people to enhance their quality of life such as new activities, skills and community activities. One staff member told us, “[Name] is learning a new communication sign each month and with support is now making a cup of tea.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. For people who might have impaired capacity, their capacity was assessed and recorded appropriately. Assessments were decision specific, and people were given every possible aid to help them decide. When capacity was absent, best interest decisions were made recognising the importance of the person’s wishes and feelings. DoLS had been applied for where needed, and staff were committed to using the least restrictive options to ensure people’s safety and wellbeing. Where people were not able to verbally communicate their choices there were tailored communication plans in place for staff to follow to ensure people were in control of their own lives. Staff received training in and had a good understanding of MCA and applied this.