The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Responding quickly to manage distress and avoid escalation
The service anticipated people's needs and recognised distress and discomfort at the earliest stage. Where people required support, we saw staff offered support in a sensitive and respectful way.
Staff were skilled at pre-empting confrontation by being vigilant and reading changes in peoples' body language. Staff knew how to use strategies that prevented any escalation of behaviours that could be described as challenging in line with the Butterfly model approach. For example, when people were anxious, and discussions could have led to altercations between people.
In their inspection, the CQC saw staff calmly and sensitively intervening using individualised distraction tactics. It was clear staff knowledge of people's needs was key and they used it effectively.
Read more about this service here.
Care provider: The Royal Star & Garter Home - High Wycombe
Date published: January 2023
Spending time with people to manage their behaviours
Staff were highly skilled at recognising when people were at risk of harm or felt unsafe. They’d built up strong relationships with people and knew from their behaviour if they weren’t comfortable with staff or their surroundings.
The registered manager actively spent time with people to observe behaviours around staff and their environment. For example, when it was recognised that a person displayed negative behaviour around a particular member of staff, the staff member was stopped from supporting the person and the person's behaviour improved.
Read more about the service here.
Care provider: Consensus Community Support Limited
Date published: December 2019
Managing pain safely
One person receiving support in a supported living home developed a condition which needed temporary medication both day and night.
Staff found the person experienced pain during the night because they didn’t want to disturb staff for pain relief. Staff liaised with the person, their GP and their pharmacist and arranged for the pain relief to be stored in an alarmed cassette box so that the person could only access their medicine during the night when it was safe to do so.
Read more about the service here.
Care provider: Community Support Service (D.D.H. Services Ltd)
Date published: March 2019
Providing supportive interventions when needed
People’s moods and emotions aren’t scheduled by a 9-5 routine; therefore, we ensure our supportive interventions aren’t either.
We employed a restorative therapist and in addition a member of care staff was trained as a therapy assistant to enable the service to respond to people’s needs. One person often became agitated and unsettled at night. The therapy assistant was able to intervene to offer the person massages at night which calmed the person and reduced their distress.
We found that by employing someone on a 24/7 shift basis, we were able to provide interventions which soothe and calm and have lowered incidents in the night where staffing levels are lowered, ensuring a safe environment for others and effective and responsive support for those distressed.
Care provider: Thistle Hill Hall (Debdale Specialist Care Ltd)
Date published: April 2018
Ensuring communication needs are met
When the care worker identified that the person’s internet wasn’t working, they knew how this would impact their social isolation as it was used to communicate with family and friends.
With the internet provider indicating the response time was six weeks, the homecare agency wrote to the chief executive and helped ensure the person was connected again within a week.
Care provider: Anonymous
Date published: April 2018
Innovate and personalised approaches to support
Staff consider innovative ways to support people during difficult times. For example, staff had been aware of one person’s anxiety about their parent’s health. The staff had considered how they could support this person at the time and to help them cope in the future.
The staff used some aspects of autism training to support the person to communicate with their parents and to share their feelings. This was supported with the use of a ‘talking tin’. The person’s relatives would record messages, and these would be in the tin when they wanted to listen to them. The staff said this had been very successful, particularly when visits home had become less frequent.
Care provider: Anonymous
Date published: April 2018
Being aware of, and rapidly responding to, health issues
Records clearly demonstrated that an out-of-hours GP had been contacted after a person communicated they had head pain. Later that day, an ambulance had been called when staff observed the same person holding their head. The following morning, staff - through their close monitoring of the person and increasing concern for their wellbeing - requested a GP visit. The person underwent a full medication review to assess their needs and provide the necessary medical treatment.
Care provider: Anonymous
Date published: April 2018