North of Tyne Supported Living

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

This is the first inspection for this newly registered service. This key question has been rated good. This meant on the whole, people’s outcomes were consistently good, and people’s feedback confirmed this. People’s needs were assessed before they came to use the service. On the whole only people who the team were confident they could meet their needs were accepted. The provider had reviewed instances when people’s needs were more complex than expected and measures had been put in place to manage inappropriate referrals being made. Care planning was not always as good as it could be. Some information was out of date or inconsistent. For example, it was unclear whether someone had a DNACPR in place or not. However, most care planning was person centred and it was clear that the care plans were completed with staff, relatives and care professionals that knew the person well. Staff had received mandatory and condition specific training. Staff supervision sessions were in the process of being completed in line with the provider's policy. Staff had received training around the Mental Capacity Act 2005 and associated code of practice. Staff understood the requirements of the MCA and worked closely with staff who apply for Court of Protection deprivation of liberty safeguards. They worked with external health professionals to complete capacity assessments and held ‘Best Interests’ meetings with multidisciplinary teams, as needed. On occasion staff needed to feel more confident to challenge decisions about people receiving routine health checks. Staff supported people to manage their health and wellbeing in ways which maximised their independence, choice and control. Some relatives raised they found there was a reliance on eating out rather than cooking, which the registered manager confirmed would be explored.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives felt involved in all aspects of their loved one’s care and how it was delivered. They felt the assessment was thorough and captured people’s needs. A relative said, “Staff know [person’s name] really well. 10 years she has been there. Same staff, they have grown with [person’s name].” Relatives discussed how they were involved and included in designing the care package and the content of the support plans staff developed.

Staff found there were effective systems in place to assess and monitor people's needs. In the various houses staff had different experiences around having the capacity to complete care records. A staff member said, “Paperwork is always filled out daily as required. However, because this service is also a lone working service there often isn't enough time to complete the more time-consuming paperwork such as risk assessments and care plan updates, as we do not like to leave the person alone for too long.” Whereas another staff member said, "I involve people in developing their care plans and risk management strategies."

Visiting professionals found staff worked well with people and understood their support needs.

People’s needs were assessed before they came to use the service. On the whole only people who the team were confident they could meet their needs were supported by the service. Action was taken to resolve any issues when they arose and lessons were learnt when people had been accepted into the service when their needs were more complex than the service could meet. Care planning was not always as good as it could be. For 4 people some information was out of date or inconsistent. For example, in 1 person’s care record it was unclear whether they had a DNACPR in place or not. This individual was not unwell, and staff acted immediately to obtain clarification. Care planning was person centred and it was clear that the care plans were completed with staff, relatives and care professionals that knew the person well.

Relatives told us that told us that their loved ones care package met their needs and staff followed the relevant guidance when supporting them. A relative said, “I have confidence in the staff, I think they are trained right. I’ve never heard anything inappropriate from them.”

Staff confirmed and we saw that they had the skills and knowledge to carry out their role effectively. Staff completed training in relevant areas to ensure they could carry out their role safely and competently. This training included supporting autistic people and people with learning disabilities. Staff supervisions were being completed in line with the company policies and expectations. A staff member said, “On line training and face to face training is always reviewed and keeping up to date with training and amended policies and procedures are always discussed in team meetings weekly.”

People’s needs were assessed before they came to use the service. The provider and staff were clear that they would only provide support to people, when they were confident they had the skills to meet their needs. Action was taken to resolve any issues when they arose, and lessons were learnt in relation to why a service had been offered to people whose needs could not be met safely. The provider had developed systems to ensure the correct staff skill mixes were available to meet service users’ needs. They were investing in staff development to provide a progressive and expert workforce.

Relatives found staff worked closely with external healthcare professionals and ensured their loved ones got all the support they needed.

Staff confirmed they had formed good working relationships with all the people involved in the care of the people who used the service. A staff member said, “We work closely with people’s GPs and community teams.”

Visiting professionals confirmed staff contacted them in a timely manner and when needed.

The provider had developed systems to ensure staff understood and recognised when people might need the support from external healthcare professionals.

Relatives told us if they needed staff would support them to access healthcare. A relative said, “They send a doctor out to see [person’s name] if they notice anything is wrong with them, otherwise they can take her the doctors and they let me know how they got on.” One person had mentioned concerns their relative was experiencing weight gain. We found this person’s health was closely monitored and they were encouraged to follow healthy eating habits.

Staff liaised with external health and social care professionals and other services such as day centres to ensure people received consistent care and support. Staff told us they felt confident to support people with managing healthcare needs. A staff member said, “We take the time to learn about how people communicate and this way we can easily spot changes. We then know when we need to contact the GP.”

Visiting professionals confirmed staff contacted them in a timely manner and when needed.

People's healthcare needs were met. The staff ensured each person had a health passport and went to the GP for an annual health check.

People appeared happy with the service. The service used a variety of methods to check people were content with the service, which included conversing in Makaton, use of picture surveys and observing for any changes in behaviour.

The staff told us they closely monitored the service to ensure people experienced good outcomes.

People’s care and support was monitored and reviewed to make sure their care and support met their needs. Although we found that for some people, this was not always completed in a timely manner but the registered manager was ensuring this was being rectified.

People were supported to have the maximum choice and control over their lives and staff supported them in the least restrictive way possible and in their best interests. Relatives told us they were asked their opinions about the support people needed. A relative said, ““They listen to what [person’s name] wants to do. Easter and Christmas activities, decorations. Chatting away to them to get them engaged.”

When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. Staff understood the requirements of this legislation. Where required these Court of Protection authorisations had been obtained and staff worked closely social workers to ensure the required documentation was sent to the court. Staff empowered people to make their own decisions about their care and support. A staff member said, “I involve people in developing their care plans and risk management strategies for example if [person’s name] needs to go into the shower then I will make sure their routine is the same and the water temperature is very safe for them. The training we complete covers capacity assessments.”

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. Staff had received training around the Mental Capacity Act 2005 and associated code of practice and felt confident applying this in their practice.