The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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How comprehensive assessment of needs can make a huge difference to the person's quality of life
Staff completed a comprehensive assessment of people's needs before they started to provide care and support. This assessment included the views and experiences of the person, their family and professionals who knew them well.
These holistic assessments reflected a philosophy of support that placed the person fully at the centre and respects their history, family culture and traditions. For one person with very complex support needs this philosophy had been made explicit in a written document that underpinned all their care and support.
The CQC were told by staff, professionals and relatives this enhanced and innovative approach had underpinned support that had made a huge difference to the person's quality of life resulting in markedly less distress and increased participation in their community and activities that brought them pleasure.
Read more about this service here.
Care provider: Dimensions Dorset West
Date published: January 2023
Emulating how that person lives to find the best fit
Preadmission assessments are very thorough. The service uses the opportunity to emulate how that person lives to when they come into the home and see if they are the right fit. They then complete a six-week review with people and their families. The services use the feedback to enhance their lives through improvement.
One person took more time to settled in and as staff got to know that person better, they realised it was do with the person's room. As a result, with consultation with the person and their family, the person moved rooms. The familiarity of the room made it easier for the person to settle in.
Read more about the service here.
Care provider: The Royal Star & Garter Home - High Wycombe
Date published: January 2023
Building a picture of the person
One autistic person with complex needs had been told by their landlord they needed to find a new home. The provider facilitated a full assessment of the person's needs, including their complex sensory needs.
Staff worked with other professionals to build a picture of the person and realised they were far more complex than anyone appreciated. Because this assessment work had not been done before this led to both a greater and a new understanding of the autistic person's needs.
This enabled the person to receive a correct diagnosis and be supported to find the correct placement.
Read more about this service here.
Care provider: Avenues South East
Date published: November 2022
Using a broad range of processes to assess need
People, and where appropriate families, were involved in pre-admission assessments to establish their care and support needs.
When people had specific clinical needs specialist health professionals had been involved in assessments. This included specialist nurses working in the community palliative care team and physiotherapists.
Assessments were completed using nationally recognised assessment tools that reflected best practice and met legal requirements. The assessments also included any specialist equipment needed such as pressure relieving mattresses and moving and handling equipment.
Read more about this service here.
Care provider: Burwood Nursing Home
Date published: September 2022
Tailoring food and drink to people's preferences from the start
People's nutritional requirements were discussed with them during the pre-admission assessment. This was used to develop a personalised nutritional care plan that included the person's likes and dislikes, portion sizes and food preference.
The service also recorded information about people's dining preferences. This included information such as where people liked to eat, who they may want to eat with and be with, whether they have a special mug or plate, what drink they preferred and any food that should be avoided due to their medication. A copy of this was available to staff in the dining room to ensure they were providing the person's preferred dining experience.
Where people required their food to be prepared in a certain way, such as with the consistency modified, the service ensured it was presented in an appetising form: for example, pureed carrots being presented on the plate in a carrot shape. At a recent party the chef made sandwiches, scones and brownies for people who required modified diets. This meant people on restricted diets were able to enjoy the party without feeling left out or different.
The service used innovative approaches to encouraging people to eat and drink, such as a drinking game which encouraged people to drink. There was also an activity called 'time for tea' involving staff from across the service. The kitchen made treats and people decorated a trolley, before being able to choose treats from the trolley.
Read more about this service here.
Care provider: Davers Court - Care UK Community Partnerships Ltd
Date published: March 2020
Understanding people, respecting their wishes
Communication difficulties wasn’t considered a barrier to people being able to express their wishes. Staff understood how people expressed positives and negatives and how they displayed that they were happy or unhappy, in pain or upset.
People's families and loved ones were involved appropriately in best interest decisions. Restrictions to people's freedoms and liberties were minimised. People were enabled to leave the home as they wished based on assessed risk. The home took the least restrictive approach with risk management and had a very flexible approach.
Read more about this service here.
Care provider: Creative Support - Doncaster Personalised Services
Date published: February 2020
Working with people receiving care to adapt décor to their needs
The décor of the home had been designed by staff in conjunction with the person to provide contrasting doorframes and rounded edges to walls to reduce the risk of injury through bumping into things.
The service noted the person had been less frustrated since the changes to the décor had been made, and they were no longer bumping into walls and furniture.
Care provider: Anonymous
Date published: April 2018
Adjusting care plans to suit the client
Care packages are set up at the person’s pace, and person and their family have the opportunity to review the first care plan before care commences so that changes can be made to get it exactly right. During the first few weeks of care, we liaise frequently with the person and their family to make tweaks and adjustments to the care plan as needed.
Read more about the service here.
Care provider: Care Concern (Homecare) Ltd
Date published: April 2018
Supporting people and their families’ wishes around healthcare
During a routine visit, the homecare agency care worker recognised signs of a stroke and called an ambulance. The person was soon discharged, much to the family’s distress, as they were concerned more healthcare support was needed. The registered manager refused to take the person home as a result, and this action is likely to have saved the person’s life as they suffered another stroke that evening.
Care provider: Anonymous
Date published: April 2018
How we use assessments, plans and strategies
Wherever possible, the service doesn’t use restraint. They adopt different strategies and approaches, enabling them to work with behaviours that may be seen as challenging, in an effective way. Some behaviours that may be seen as challenging can often be an expression by the person of a deeper anxiety that we need to try to understand and support them with.
Where they recognise that low levels of physical restraint may be necessary – such as when more than one person is required to deliver personal care where resistance is expressed but the care is essential – they’ll undertake mental capacity assessments and complete best interest decision documents involving all concerned.
This approach ensures the decision-making is evidenced well and any measures put in place are proportionate to the person’s needs. Any documentation is updated on (at least) a monthly basis to ensure that the actions are still appropriate.
Read more about this service here.
Care provider: Brunelcare’s Deerhurst Care Home (with Nursing)
Date published: April 2018