Creative Support - The Houghtons

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.

Peoples’ needs, and choices, were assessed and took into account their diverse needs and preferences before they went to live at the service. Staff supported people to live healthier lives, attend health appointments and support people with their complex needs. The provider worked in close partnership with external health and social care professionals to plan, deliver and continuously review people's care to ensure that outcomes were positive and consistent. People were supported in accordance with the Mental Capacity Act. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 and relatives where applicable were fully involved in the assessment process. The accommodation was shared and the assessment process made sure people living at the service were compatible to live together.

So that each person’s move into the service was a positive experience the provider completed a transition period that included lunchtime visits, overnight and weekend stays. The provider looked at the specific training staff would need to support the person moving into the service, support from healthcare professionals and any resources needed.

Records confirmed that people received a full assessment of their needs in an all-inclusive way, considering their culture, past experiences, physical, psychological and social needs. Care plans had been developed following a robust assessment that were individualised and reflected their preferences for how and when care and support should be provided.

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. One person told us, “I wrote my care plan and I am listened to when I talk about my care.” People were supported to plan and prepare their own meals. They were encouraged to make healthy choices and to learn new skills when preparing food. We observed people preparing their own lunches with support. They told us they were happy with this arrangement and felt able to make choices which reflected their dietary needs and tastes.

Staff confirmed they were provided with good support and training to meet people's needs effectively. We saw that an ongoing schedule of training was in place, to ensure staff kept up to date with best practice, this included specific training in relation to people’s health conditions and learning disabilities. One staff member told us, “We have very good training about various subjects which are appropriate to our roles and to make sure we are always up to date with new practices.” Staff explained how they supported people to attend appointments or to remind them about these and ensure they met with healthcare professionals. We were told by all staff we spoke with that they promoted healthy lifestyle choices, with diet, exercise and healthy choices.

Records demonstrated that staff supported people in the development of their care plans which included people’s goals and outcomes. Records fully demonstrated how people’s care and support needs were being met and were reviewed regularly or when people’s needs, goals or aspirations changed.

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. For example, staff and people using the service had developed hospital passports and health and well-being guidance for each person that provided information health professionals needed to support them. This included personal details, the type of medication they were taking, and any pre-existing health conditions. If needed there was information about any communication aids and how they could be used so health staff could communicate clearly.

Staff told us they worked collaboratively with people, relatives and with other services if people needed support. For example, we saw how the staff had been working with 1 person, their family and health professionals to determine if the person had a hearing impairment.

Records showed that advice from health professionals was discussed and included into people’s care plans and risk assessment. It was also discussed in staff meetings to ensure staff were up to date with people’s changing care and support needs.

Feedback from partner agencies supported our judgment that staff at the service worked together effectively to meet peoples’ needs.

Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. One person told us, “The staff support me to go to hospital appointments as I get anxious about going on my own. I do go to the dentist and opticians on my own and the staff help me organise those appointments.” A relative commented, “The staff are very good at supporting [family member] to make healthy choices. They don’t dictate but discuss with them. In the end they respect [family members] decisions but they do try to guide them towards the healthier options.”

Staff confirmed they supported people with their health appointments and supported them to make healthier choices. One staff member told us, “We support people to go swimming and on walks and we support people to visit the consultant about their epilepsy so it can be monitored properly.”

Records confirmed that staff received training in how to meet and appropriately manage people’s care and support needs. For example, we saw that staff received training about Epilepsy and how to administer rescue medicines if they were needed. People had health action plans in place that detailed people’s health care needs and conditions, and the actions staff needed to take to keep people fit and well. Staff ensured people routinely attended scheduled health care appointments and had regular check-ups with a range of external, community-based medical and health care professionals.

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. People met with a member of staff who was a named key worker to discuss their needs, support plan and how they were feeling. These were recorded and available in a format suitable to meet a person’s communication needs. These meetings helped staff to identify any decline in a person’s wellbeing as well as monitoring their progress in meeting objectives.

Staff told us they monitored people’s wellbeing throughout their shift and if they had any concerns they would report them to a senior member of the team. One member of staff commented, “We are a small service and get to know people very well. For those who are not able to tell us verbally if they are unwell or unhappy, we get to learn how they communicate and are able to recognise their body language. So, we can tell pretty quickly if we think something is wrong and can then sort it out.”

Records demonstrated that where people’s needs had changed, staff had updated peoples care plan to reflect these changes. Processes were effective and ensured safe monitoring of people’s health care needs. Records were completed daily to support monitoring and review of people’s needs. The outcome of all audits, monitoring checks and feedback were routinely analysed to identify issues, learn lessons and develop action plans to improve the service they provided to people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We found that people were supported in line with the principles of the Mental Capacity Act (MCA). For example, people and their relatives told us they were involved in decisions about their care. One person said, “l Iead my care and I am responsible for my own care plan. If I want to change something I am listened to. The staff respect my decisions.” A relative commented, “The staff always seek permission from my [family member] before they do anything. They always involve me when needed if there is a decision to be made.”

Staff we spoke with had a good understanding of the Mental Capacity Act and told us they valued people’s choices. Staff described how they would support people to make informed choices by talking through their options and describing benefits of healthy or positive choices with people.

The registered manager and provider had processes in place to support people where they may not have capacity to make decisions. This included completing assessments and putting decisions in place in people’s best interests.