Palmarium

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

We reviewed all 6 quality statements in this key question.

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.

Relatives told us that people’s communication could be supported more effectively. However some relatives told us people’s needs were assessed and they were involved in discussions with staff and the registered manager regarding care and support provided. People were involved as much as possible in assessments of their needs.

Staff and management were aware of the importance of assessing needs and told us this was part of the care management approach. People’s needs were being assessed and reviewed regularly. Staff told us they were identified key workers which meant they worked with specific people and took time to get to know them in detail and understand their needs.

As part of the transition work carried out before people moved into the service, management carried out formal assessments of people’s needs. This included assessments of people’s health needs and their social care needs. Assessments were recorded and used to produce a care plan.

Relatives told us food choices had been poor for people. However, staff were now supporting people to cook their own meals. Relatives told us this was helping to develop people’s daily living skills. We were told by relatives that communication boards were used to support people to make their choices of activities, although at times they felt these had not been used consistently. Relatives also told us that people could be more stimulated within the service and be supported to access the community more often.

Staff had training to support people with learning disabilities including positive behaviour support. Staff told us they felt supported by the registered manager with regards to any incidents linked to people’s behaviour. Staff were able to seek guidance from the registered manager and support staff from the providers head office.

The service had information about people’s specific needs from local healthcare professionals who knew people well and could advise on best practice. Regular multi-disciplinary meetings took place to identify ways to improve outcomes for people. The provider was aware of the CQC guidance ‘Right support, right care, right culture’. This guidance outlines what we expect good care to look like for autistic people and people with a learning disability.

Relatives told us that they had attended meetings with the registered manager and external agencies where needed.

Staff told us that they were involved in meetings with external professionals about people’s care and support. Staff told us they felt listened to and this involvement supported good outcomes for people that use the service. One member of staff told us, “By working as a team, including everyone I feel we have made [person’s] life a bit better. It shows that teamwork is important.”

The provider worked with health care professionals who felt that their suggestions and the plans that had been developed for people were adhered to by staff at the service. However there were times when some professionals felt it was difficult to access information from the provider.

People’s care records demonstrated staff worked with other services to make sure people’s needs were met effectively.

Relatives told us they were involved in discussions regarding people’s health. Staff were trying to improve health outcomes for people. For example, staff were trying to improve the healthy food options people had although this was still a concern for some relatives.

Staff told us they supported people to attend any health appointments and talked with health professionals updating them with changes to people’s needs. Staff told us they had access to healthcare records and kept them up to date with all involvement from health professionals.

The provider had health information in easy read format available for people who required it to support their understanding of their health needs.

We did not receive any concerns regarding monitoring of people’s outcomes from relatives.

Staff told us they used daily notes to record and monitor activities, needs and behaviours for people in order to improve outcomes. For example, staff told us they recognised how important it was for people to record all activities and work to identify any triggers to people’s behaviour. Staff told us this work helped to prevent distress reactions and improve outcomes.

The provider was implementing an electronic system to record people’s information. This was not fully implemented at the time of our assessment and had proved difficult for some external professionals to access information. The provider did have information available in paper form and had plans to further develop the electronic system.

People were supported to make their own choices day to day. People had access to communication tools to make choices on which activities they were supported with.

Staff received training in the Mental Capacity Act 2005 (MCA) which helped them to understand the principles of the MCA. Staff understood the process of best interest work and the importance of supporting people to make their own decisions.

The provider had a policy and procedures to support staff with the Mental Capacity Act 2005. Records demonstrated that people’s capacity had been assessed. However, the capacity assessments were not always in depth or individualised.