Mirabeau

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 good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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’s support plans were meaningful and focused on what was important to them. Staff could access care plans via a new electronic system which had been recently introduced. People and those involved in their care took part in assessments and reviews. Their views and opinions were respected, listened to and implemented as part of the day-to-day support. A person’s relative told us, “I always attend [person’s] annual review and raise issues there.” Staff had specialised training in how to support people with a learning disability and or autistic people, to meet their assessed needs.

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. The provider had an ‘in-house’ team including a Positive Behaviour Support (PBS) lead to ensure care and treatment reflected best practice guidance. People’s nutrition and hydration needs were met, and people had access to their preferred meals at a time they chose. For example, we spoke with 1 person who was enjoying a late breakfast of bagel and eggs. A relative told us, “[Person] has a balanced diet, they are a picture of health, and their skin is beautiful. Every Sunday [person] has a roast dinner. That is so homely.” Another relative said, “[Person] chooses the recipe, then they go to the shop and buy the ingredients and then [person] helps make it. [Person] did make a cake, but they refused to share it!”.

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. Professionals were engaged in reviews and assessments to ensure relevant information was incorporated into people’s care plans. A professional who works with the service told us, “I am informed of how to communicate with the individual, what they prefer to be called. Staff go through the ‘About Me’ section of the care plan and the ‘Hospital Passport’. I receive a full briefing before meeting the individual.” People had health action plans to support joined-up care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. A professional who worked with the service told us, “The manager and team do try to ensure the individuals have healthy options at mealtimes. [People] are kept active mentally and by doing physical activities for their own well-being, and the (staff) team all use positive active support and encourage the individuals to grow and continue to develop new skills.” For example, we saw 1 person who had returned from a horse-riding lesson, with their jodhpurs and riding boots on. Other people enjoyed going swimming, bowling, on bike rides, or to the gym.

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. A person’s relative told us, “Staff monitor [person’s] weight. [Person] is just right, not too big and not too small, staff look out for that.” Staff used data they had recorded, for example about a person’s seizure activity, to feed into improving outcomes for people when working with other professionals. Staff also introduced new ideas to people to enhance their quality of life, such as new activities, skills, work and education opportunities. However, we identified some of the daily care notes could be more detailed to show how people spent their day. The provider told us they would act on this feedback.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People made their own choices and decision on a day-to-day basis about what they did, what they ate and how they filled their time. Where people were not able to verbally communicate their choices there were tailored communication plans in place for staff to follow to ensure people were in control of their own lives. Mental Capacity Assessments were completed to check whether people had capacity to consent to specific areas of their care and support. Deprivation of Liberty Safeguards had been applied for where required, and staff were committed to using the least restrictive options to ensure people’s safety and wellbeing.