Rapid Review & Resettlement

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

Assessments were completed prior to admission to ensure the service was suitable and staff had the information needed to provide effective care and support. People’s support plans were focused around promoting quality of life, achieving goals and ensuring they remained in good health. People’s nutrition and hydration needs were met, with records kept, evidencing what people had consumed. Staff documented successful outcomes and shared these with people’s relatives. The provider had been proactive in seeking ways to improve people’s experiences, including the use of electronic equipment to reduce the need for physical observations, which people may have found obtrusive. People’s consent was sought, and they were encouraged to make decisions for themselves.

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 told us they had been involved in the assessment process and the setting up of the care plan. One relative stated, “Yes, very much involved and I am reviewing it [care plan] tomorrow when I visit.”

During our on-site visit, we noted one person’s assessment was not stored within their care records, and the provider took some time to locate this. We advised them to ensure the assessment remained part of the care plan. Ongoing discussion and assessment of people’s needs was completed. This was done formally at weekly team meetings. The current management system also supported this process, as the service manager worked on shift 4 days per week, so was actively involved in people’s care and support.

Assessments were completed prior to people’s admission to the service. This information was used to help complete the care plan, risk assessments and other support related documentation.

Relatives spoke positively about the support provided with nutrition and hydration. Comments included, “Very happy, [relative] is eating much more variety and lots of fruit and veg,” and, “Initial impressions, it is fantastic. [Relative] is trying more stuff now. They went out for a pub lunch and had tartare sauce for first time and loved it.”

People were supported to plan and shop for their meals, with advice and guidance provided around maintaining a balanced diet. Where people had specific dietary needs, for example one person required a high protein, low carbohydrate diet, these were provided in line with guidance. Staff kept a log of what people had eaten and drank and weighed them monthly to monitor any weight gain or loss.

People’s care plans contained sections relating to support with eating and drinking. These explained what support the person needed and what they could do for themselves. For example, one person’s stated ‘I can choose what I like to eat and I can feed myself, but I need support to choose and eat healthy foods. I would like staff to sit with me whilst eating.’

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

People were supported to stay well and live healthier lives. Relatives spoke positively about the support which had and continued to be provided, especially relating to personal hygiene. One relative told us, “The last 4 to 5 months in the previous care home, [relative] was losing weight, rarely went out and they [staff] couldn’t even do basic care for him. Since [relative's] first day here, they [staff] are constantly reassuring him, he is eating and sleeping well, going out every day, showering twice a day, he has had a haircut and shave. He had not had a haircut for over 12 months before coming here.”

The provider was mindful of the importance of timely access to medical professionals, including dental care. A relative stated, “I have been speaking to [provider’s name] about dental treatment locally and they are sorting that, as less stressful for [relative].”

Staff used the Disability Distress Assessment Tool, which was used to check for signs of distress in people. This provided staff with information on what each person’s normal presentation was, and what non-verbal signs they may display to indicate they were upset or in distress. People had detailed Health Action Plans, which explained their health needs, the involvement of any professionals and any actions which needed to be completed. The documents contained a summary of people’s health conditions, things which may affect their health, support they required to stay well, support needed with personal care tasks and information on medication, what is was for and how to administer this. Each person also had a hospital passport, which would be taken with them when attending hospital or medical appointments; these contained key information about the person and their support needs. We found information within these documents mirrored the information within care and support plans.

At their previous placement, one person had been observed throughout the night by a staff member, due to concerns about ‘sudden unexpected death in Epilepsy’ [SUDEP]. This had impacted on their sleep. Rapid Review and Resettlement considered this to be highly restrictive and were reluctant to do the same. Following a best interest meeting, it was agreed to trial the use of technology as an alternative. The provider built a vibration sensor into the bed frame and installed an audio monitor, which enabled remote observations to take place. This had led to an improved sleep / wake cycle and reduction in restrictive practice.

Staff supported people to set and accomplish goals and where possible achieve positive outcomes. Staff ensured relatives were kept informed of what people had been doing and progress made. A relative told us, “[Relative] now has a life he has not had. He was a prisoner in his last placement. Here staff send me pictures of what they have been doing. I have had text updates and telephone calls. Care has been seamless. He is a calm, young man now.” Another relative stated, “[Relative] is just having the best time. He first went out the day after moving in, and has been out every day since. They [staff] have given me hope.”

Each person being supported had an outcome document which detailed any goals, activities and achievements the person had made. For example, one person, at their previous placement, had only accessed the community twice a week and had often not got out of the vehicle. As a result, the person had not been completing activities they enjoyed. Since moving to Rapid Review and Resettlement, the person had been to a shop for the first time in years, been 10 pin bowling, cycling, swimming, travelled on public transport and eaten out at restaurants.

Relatives told us they had been involved in decision making and had been notified of any legal frameworks being in place, such as Deprivation of Liberty Safeguards (DoLS). One relative stated, “[Relative] has a DoLS in place, however, this is the only place where it has not been necessary to actually restrain him.” Another relative said, “[Relative] is kept safe but not restricted in the way they have been at other services.”

Staff sought people’s consent and involved them in decision making. People were supported with making simple day to day decisions, such as what to wear, eat and what activities they wanted to complete. Staff explained they way in which consent was sought. One staff member stated, “Either verbally or by using communication aids such as the Picture Exchange Communication System (PECS) and Makaton. Another staff member said, “We seek consent verbally and we back that up by checking and asking a second time. If the person is non-verbal, we would use their preferred method of communication.”

Care plans contained information about people abilities relating to consent, capacity and decision making. Mental capacity assessments and best interest decisions had been completed where people lacked capacity to make particular decisions. Where DoLS applications had been granted, the provider had shared a document with people and relatives, which explained their rights under the Mental Capacity Act.