The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Support plans and training to meet non-binary needs
People were involved in development of their support. For example, one person identified as non-binary and had experience of having a positive behaviour plan (PBS) but had never been asked to have input. The person was supported to see what they wanted to take ownership of. This ensured that staff understood the correct preferences and pronouns of the individual. They were encouraged to say what was important to them and how they wished to be identified, not only through gender but also through characteristics and presentations.
The person recognised the efforts that staff were going to in ensuring they did not refer to the individual using the wrong pronouns.
Prior to the bespoke training of the person's positive behaviour support plan to staff, the registered manager spoke to the person to ensure they were aware of what the team was being trained in and they were asked for their input. It was at this point that the individual was really able to open up about what certain behaviours meant and what they may be trying to communicate.
Read more about this service here.
Care provider: Kingdom Youth Services
Date published: March 2023
Person-centred care approaches and training
Lee Mount Care Home do not take a blanket approach to everyone and finding out as much as you can about each person - about what makes them who they are. That includes their history, their interests, their beliefs. From knowing that information, you can tailor the support that you offer them.
They provide some practical examples about what they do and how they build up staff capacity through associated training and support. Read the full blog here.
Care provider: Lee Mount Care Home
Date published: March 2023
Meal time choice
The service kept routines to a minimum. People chose when and how to have support. For example, when they needed personal care and where they wanted to have their meals. Staff knew people's preferences and respected their choices. On the day of the inspection, the CQC saw people having lunch at the time of their choosing. They were served food in a timely, non-rushed manner, whatever time they chose to come for meals. The atmosphere was very relaxed and allowed meaningful interactions between people and staff.
Read more about this service here.
Care provider: Byron House Care Home
Date published: January 2023
Meaningful Care Matters (MCM) Butterfly model for person-centred dementia care
The home had adopted the 'Meaningful Care Matters (MCM) Butterfly' model approach to care, which encompasses a 'feelings-based' approach to people living with dementia.
This approach has a focus on dignity, choice, and positive behaviour support. The home had recently achieved the MCM level 1 accreditation which is the highest accolade and demonstrated exceptional person-centred dementia care. The registered manager credited this to the ambitious dementia care manager who had championed the cause and led the team through this achievement.
The project was aimed at promoting a respectful, loving, family environment so as to further improve the lived experience for people in the home as well as those living with dementia at all stages of their journey. During the inspection it was very clear to see this aim had been achieved. All staff had attended the butterfly model training and found in invaluable.
Read more about this service here.
Care provider: The Royal Star & Garter Home - High Wycombe
Date published: January 2023
Video support plans
The provider had been so impressed with the innovative creation of video support plans they were now rolling this practice out across the other homes they operate. Staff sought advice and feedback from everyone involved in people's care.
Read more about this service here.
Care provider: Grizedale
Date published: January 2023
Specialist professional support to develop the support plan
One autistic person had spent many years in assessment units and had not been to their parents' house for more than a decade. The provider worked with specialist professionals to develop an extremely detailed support plan that ensured staff supported the person in a consistent way at all times.
The slightest deviation from a consistent approach would unsettle the person and lead to a failure of the plan to reduce their daily supervision. The person was able to reduce their support from five people at once, to two support staff due to this carefully delivered plan, which gave them more privacy and independence.
Read more about this service here.
Care provider: Avenues South East
Date published: November 2022
Drawing on expertise but leading by the people they support
All support was developed with people, relatives, staff, therapists, medical and legal professionals involved. Staff encouraged people to take the lead role in developing a plan of personalised support which met their individual needs and aspirations. Staff valued and listened to people's opinions.
Support plans explained the strategies and care required to consistently achieve positive outcomes and meet people's goals. These were regularly revisited and reviewed. People had been empowered to take control of making arrangements and were given the autonomy and independence to try new experiences.
Read more about this service here.
Care provider: J S Parker Limited North East
Date published: February 2020
Finding the most comfortable way to involve somebody
The service had noted that some people didn’t engage in reviews. Staff worked with those people to ensure they were totally person-centred.
For one person who didn’t engage, they worked together with staff to prepare for the meeting; they decided where they wanted to have the meeting and the food they’d like to make for it. On the day of the meeting, they saw that the person was engaging as first but then displayed some unhappy gestures.
The staff and relative responded to the person wanting them to come to their own room. The review continued on the floor of the person's room and they were engaged and signing the whole way through. This was a much more positive experience.
Relatives stated that: "We were all down on the floor writing on bits of paper. It makes you think, it involves them totally. They had to write things down too, it’s really interactive, I feel so positive about it."
Read more about this service here.
Care provider: SENSE - 89 Hastings Avenue
Date published: April 2019
Extra person-centred support for new residents
When people moved in, an extra member of staff was on duty to help them and their family settle in. This included working one-to-one with them, remaining with them to show them around the building and support them and their family with the admission process. Staff collected information by talking with the person and their family.
A more in-depth care plan was developed as they settled into the home. Care plans in relation to health and personal care were 'live' on the computer system and therefore up-to-date and relevant. As changes occurred such as a GP giving new advice, the staff team would be given guidance using the in-house computer messaging service instantly and the care plan would be amended that day.
Read more about this service here.
Care provider: Wisteria House Dementia Care Ltd
Date published: January 2019
Establishing a process for tailored support
We created a system called MyPlan. This allows us to tailor support to each individual and adjust it according to their needs. This process begins when we receive a referral, at which point we meet with the individual and get to know them to understand what they like and their support needs.
We can then develop their support and where applicable, tenancy, around them. We then create a plan for the person, outlining their support, activities they’d like to do and goals they’d like to achieve. Their plan is reviewed and adjusted on an ongoing basis to ensure we’re consistently supporting people in a way that suits them, while supporting them to do the things they want.
Read more about this service here.
Care provider: Avenues
Date published: April 2018
Pursuing personal objectives through care planning
There were care planning strategies providing detailed guidance for staff on how to steer people towards personal objectives. For example, a person living with a dementia-related illness was at risk of social isolation and there were clear strategies for staff to guide the person towards integration and a more fulfilling life.
Care provider: Anonymous
Date published: April 2018
Introducing software to improve care planning
We’re preparing for the introduction of person centred planning software (PCS) for care plans, following its successful implementation at other Belong villages. This has been shown to enable us to be more responsive to the needs and wishes of the people we support, with information being shared instantly but securely. Evidence and information relating to people’s records is more easily accessible, facilitating a timely response in all areas of their support.
Read more about the service here.
Care provider: Belong
Date published: April 2018
Updating care plan notes electronically
People’s confidential personal information was always securely protected. Mobile phone technology was used to record care notes. This included call arrival and departure times, care or support provided, and any problems or issues the care coordinators needed to be aware of.
Care provider: Anonymous
Date published: April 2018
Incorporating healthcare guidance into care planning
Where healthcare professionals provided advice about people’s care, this was incorporated into people’s care plans and risk assessments.
One person had been seen by the speech and language therapist and a pureed diet had been recommended. Within the persons care file there was clear guidance to staff on how to manage nutrition and actions to take if food was declined or the person experienced choking.
Care provider: Anonymous
Date published: April 2018
Scheduling care planning appointments electronically
The electronic care plan had a calendar that listed the person’s upcoming healthcare appointments, as well as care plan review dates, medication reviews, their birthday and the birthdays of others special to them.
This was automatically populated by information put into the care plan in other areas. This was a useful tool to help staff ensure they didn’t miss important appointments, and reviews of care plans and risk assessments weren’t missed. There was a reminder which stayed ‘live’ until the task was actioned, so the task couldn’t be ignored.
Care provider: Anonymous
Date published: April 2018
Helping people achieve objectives and wishes
The registered manager promoted a scheme called '3 wishes' where people who needed care and support were asked what three things they’d like to achieve during the year. For example, one person had wished they could see Elvis, so the registered manager ensured an Elvis impersonator performed at the service. Photographs had been produced following the event and shared with people using the service to celebrate the event.
Care provider: Anonymous
Date published: April 2018
Involving people in decisions about menus
People were fully involved in decisions about meals served. There was a food forum which enabled people to be part of menu planning. When any changes to the menu were planned, a group of people met with the main chef to discuss this. One person said: “We go through every meal choice and say whether we want it or not. When the menus have been running a while, we ask people what they like and don’t like and then meet again to make changes if needed.”
Care provider: Anonymous
Date published: April 2018
Helping people understand their care
The service uses various practical ways to help people with learning disabilities and sensory deprivation to understand the care they need. For example, to help people prepare for medication, care workers roll an empty tablet jar in their hands, before each meal a scented candle is lit and before waking people up, fresh coffee is brewed and the aroma can be smelt around the home.
Care provider: Anonymous
Date published: April 2018
Helping people assess pain
The provider used the Abbey Pain Scale for people living with dementia or for people with communication difficulties. The pain scale is an instrument designed to assist in the assessment of pain in people who are unable to clearly articulate their needs. It enables the care worker to observe changes in facial expression, behavioural changes and psychological changes. By building pain assessment into existing care plans, it helps staff to recognise when pain occurs. For people who experienced pain, their needs could be met in a proactive way and ensured as far as possible that pain and discomfort were reduced to increase their wellbeing.
Care provider: Anonymous
Date published: April 2018