Sutton Court

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• 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

We assessed 6 quality statements within the effective key question. We found improvements had been made since the previous inspection in March 2022. This meant the effectiveness of people's care, treatment and support achieved good outcomes. Systems were in place to promote consent to care and treatment; assessment of people’s needs and support to live healthier lives. Staff teams and external services worked well together. People, family members and external health and social care professionals told us they felt the service was effective.

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.

People and those close to them had been involved in developing their support plans to meet their individual needs and preferences. Support plans showed detailed assessments of people’s needs and clear guidance for staff to follow to manage them. For example, one person told us how they were involved with their needs assessment and subsequent support plan, explaining they had a “picture book” showing staff their rooms as well as things in the local area. There was also a detailed plan of visits again with photographs to help the person visualise the plan. Assessments were completed before people moved to the home. This included where appropriate, consultation with other professionals involved in the person's care and family members. Support plans were then developed to include people's identified needs and the choices they had made about the care and support they wished to receive. Support plans contained details about the person’s preferences, occupation, hobbies and interests.

Support plans were detailed and person-centred. Staff told us the details in the plans reflected the needs and wishes of each person. For example, autistic people had plans describing their sensory needs. People who needed them had positive behaviour support plans. One staff told us, “If I am not sure, I ask someone and read the support plan, I have had training about PBS it helps me to understand why people might do things.” Support plans and related records viewed showed consideration and reflection of current legislation and practice guidance. For example, oral health support plans were in place. Records identified meetings with people and families took place and contained relevant information.

People received joined up care and support as staff worked well with professionals. People’s health and care needs were understood, and information was communicated effectively between services to ensure their needs continued to be met. Staff and management made sure health professionals were aware of people’s needs. Staff told us they always had up to date information from professionals about any changes to people’s needs. The registered manager described a good working relationship with partners in care, they gave an example of meetings for one person to review their mental health condition, and the team involved, felt their needs were being met as their condition had not deteriorated and they were accessing more information to help the person. Visiting health and social care professionals provided positive feedback about the staff and service. People had health care passports in place which were available should they need to attend appointments. The health care passports helped partners in care understand people’s communication preferences, their health and care needs and who and what was important to them. People’s care and support plans were updated with professional advice. Where needed, the registered manager engaged with health and social care professionals which supported staff to create additional guidance.

People were encouraged and supported to improve and maintain their physical health. One person told us, “Staff support me with all sorts, going out and they take me to the doctors.” Another person told us how staff had supported them to give up smoking. The person was clearly pleased with their achievement. Staff, who knew people well supported them to attend health appointments. This meant further information required by professionals during the appointment would be available. Any decisions or further treatment required following an appointment would also be known by the service. Support plans included information about people's past medical history and how current medical needs should be supported. People had hospital passports and health action plans in place. External health professionals told us they felt they were contacted appropriately, and any recommendations made were followed by staff. One health professional told us, “[Name of home manager] is open to working with external professionals and with actioning any recommendations made promptly.”

People had support plans which were monitored and changed to reflect changing needs. We observed staff responding effectively when people changed their minds about the support the wanted. For example, one person was keen to have some pictures they had created put on the wall. They expressed they wanted to do that before the activity which had been planned with them took place. Staff worked with the person to accommodate the change, demonstrating flexibility and good humour. The registered manager, home manager and staff monitored people’s outcomes and knew how to seek advice and support from health and social care professionals when required. The registered manager told us, “To keep up to date with knowledge I can access the British Institute of Learning Disabilities (BILD) website, and I receive lots of emails from professionals giving me up to date information, like Autism care passports, communication passports, health forms, which can then be given to the managers of the homes.” People had person-centred care and support plans, which included best practice guidance and were updated to reflect changes to their needs. Staff confirmed they completed daily records which were reflective of people’s support plans.

Where people had capacity to make decisions, we saw they consented with the proposed care and support. One person said, “I choose staff I want to help me.” We observed staff offering choice and asking people’s views throughout the assessment visit. People's wishes and needs were documented. People's right to decline care was understood by managers and staff and they were able to talk in detail about people’s best interest decisions. One staff member said, “We aways ask people so they can make choices.” The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. The registered managers demonstrated processes were in place to support people to make their own decisions when possible and to carry out appropriate assessments and best interest decisions if needed.