The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Sourcing appropriate healthcare support to achieve outcomes
People had achieved exceptional outcomes to meet their health needs. For example, Staff worked with a GP and hospital to arrange a joined-up approach so one person could receive two different interventions under one sedation. This resulted in the early detection and treatment of a serious illness.
Staff worked very closely with a range of health professionals to ensure people's good health and wellbeing is maintained. They were exceptional in sourcing appropriate healthcare support for individual people. For example, they recently sourced a specialist learning disability Macmillan nurse.
Read more about this service here.
Care provider: Orbis Support Offices
Date published: March 2023
Learning boards, clinical meetings and other ways to monitor people
Learning boards had been created, for example, for diabetes, displaying the risk factors, possible complications, signs to look for and actions to take. There was a similar learning board on end of life care. These had improved staff knowledge and given them more confidence when supporting people in these areas. Infection control refresher posters provided prompts for staff, acting as constant reminders.
Nurses attended regular clinical meetings where key clinical issues were discussed, such as wound management, weight loss and falls prevention. Action plans were in place to ensure that issues were addressed and reviewed, for example, referrals to dieticians or specialist nurses. The registered manager met daily with heads of departments to ensure key messages about people were shared in a timely way. Daily handover meetings were held so staff had up to date information about the people they were supporting.
Read more about this service here.
Care provider: Eglantine Villa
Date published: February 2023
Circle of support meetings
A wide range of health and social care professionals were involved in the development of support plans and took part in regular circle of support meetings if appropriate.
Healthcare professionals contacted took the opportunity to contribute to the inspection and all described the support people received as proactive. One health care professional described them as "incredibly proactive and patient centred.
Read more about the service here.
Care provider: Dimensions Dorset West
Date published: January 2023
Sharing personal experiences of MND with others using the service
One person, who had a medical background, was living with motor neurone disease (MND). They offered to talk with staff in small groups to share their experience of the condition, how it progressed, the problems they faced and treatments. In addition to this, an MND nurse specialist provided training to the staff team.
Read more about this service here.
Care provider: Burwood Nursing Home
Date published: September 2022
Annual health checks, screening and primary care services
People were supported to attend annual health checks, screening and primary care services. People had health actions plans/ health passports which were used by health and social care professionals to support them in the way they needed.
Read more about this service here.
Care provider: Dimensions Dorset West
Date published: January 2022
Using Malnutrition Universal Screening Tool (MUST) tools to deliver outstanding care
At Vida Healthcare there is a whole team approach looking to deliver outstanding care in regards to people’s food and drink. The key considerations are to provide person centred care, each individual will have a bespoke care plan pertaining to their individual needs.
Vida Healthcare use the Malnutrition Universal Screening Tool (MUST). MUST’ was specifically developed as a tool that can be used for screening for all adults in all settings, whether or not physical measurements of weight and height are possible. You can read more about MUST here.
Vida Healthcare works collaboratively with the dietetics department at Harrogate District Hospital and the local universities, dietetic students have learning opportunities and placements spending time with the Vida team. It is essential to have a multi-disciplinary approach to provide specialist dementia care to ensure person centred care and joined up working in daily practice.
Read more about this service here.
Care provider: Vida Healthcare
Date published: January 2022
Using Functional Behaviour Profile within dementia care home
Staff also used a Functional Behaviour Profile (FBP) which they found excellent in ascertaining individual’s cognitive score, and in turn comparing and contrasting it with the other people living in the home.
The FBP is a nationally recognised assessment which looks at various cognitive areas such as using tools like a hairbrush or razor, completing tasks such as fastening buttons, decision making process time and support needed, showing enjoyment and understanding simple requests.
This enabled the staff team to not only provide appropriate activities and stimulation but also to 'match' people at similar stages of dementia. The FBP was also discussed in the relatives' yearly reviews and this helped loved ones to understand the speed or direction in which the individual's dementia was progressing. This gave loved ones time to prepare for the next stage and consider future support, particularly in enabling stress-free and enjoyable visits for all involved.
Read more about this service here.
Care provider: Wisteria House Dementia Care Ltd
Date published: November 2021
Using artificial intelligence in nursing homes
Havering Care Homes are leading the way with digital innovations in social care, they recently introduced the use of artificial intelligence (AI) across their nursing homes. We spoke with Mike Armstrong, Managing Director of Havering Care Homes to find out more about how AI has helped support his staff and residents.
Read the full article here.
Read about this service here.
Care provider: Havering Care Homes
Date published: June 2021
Doll therapy
Within this care home supporting people living with dementia, doll therapy based on best practice research was used with positive effect. We saw one person take a doll for a walk in a pushchair. The doll had reduced the level of anxiety they experienced because the doll gave them responsibility and something to focus on. A relative commented: "The change in her is unbelievable, she’s so content."
Read more about the service here.
Care provider: The Royal Star & Garter Homes - Solihull
Date published: March 2020
Persisting to improve health and wellbeing
Case managers highlighted the importance of consistent and timely interventions to make sure people got the support they were entitled to. This had a significant positive impact on people's lives.
One person who was barely responsive during the first assessment was supported to move out of a rehabilitation unit into their own home and began an intensive community rehabilitation programme. They were now able to have independent time in the shower, had attended music concerts and had been abroad on holiday.
Read more about this service here.
Care provider: J S Parker Limited North East
Date published: February 2020
Reducing urinary tract infections (UTIs)
The provider had introduced urinalysis kits and trained all staff in their use for the early identification of potential UTIs; one of the primary reasons for hospital admissions. This had produced very positive results, with a decrease of 60% in the number of related hospital admissions among people who use the service.
Read more about this service here.
Care provider: The Good Care Group
Date published: April 2019
Mapping recovery progress
We use the ‘recovery star’ with people who need care and support to allow them to identify goals which are meaningful and purposeful to them, and also show them their growth and development.
Recovery can be a slow process, but by using the ‘recovery star’ to map progress we’re able to clearly see progress, even when it appears things have been stagnant. This gives people a great sense of achievement, which in turn encourages them to continue on their pathway even if it feels like things have slowed.
Read more about the service here.
Care provider: Thistle Hill Hall (Debdale Specialist Care Ltd)
Date published: April 2018
How a holistic approach incorporating positive wellbeing can help
This service takes a holistic approach to care and identifies triggers for behaviours before they reoccur and become unmanageable.
They’ve found that innovative approaches, such as the introduction of Namaste Care™ sensory therapy into their everyday practice, has supported people to become relaxed through touch, smell and taste, achieving incredible results.
This promotes positive wellbeing and a sense of feeling valued, significantly reducing the need for pain relief and antipsychotic medications. This practice has now been adopted throughout the organisation because of the success stories at Belong Crewe.
Read more about this service here.
Care provider: Belong Crewe Care Village
Date published: April 2018
Monitoring and updating care needs
When a person was admitted to hospital, the service had a form they used to track the person's progress. Team leaders reviewed people's needs before they returned home by liaising with the person, family and hospital. This was to make sure any changes to care and support were put in place.
Care provider: Anonymous
Date published: April 2018
Making digital connections
A care home and hospital worked together to link a webcam so that appointments could be carried out virtually. It enabled a hospital doctor to advise on treatment and any suggested medication could be forwarded to the person’s GP for prescription.
Care provider: Anonymous
Date published: April 2018
Responding to changing health needs
When a person’s mobility suddenly deteriorated, prompt contact was made with the relevant health professionals. This ensured they received a holistic assessment of their needs from all professionals involved in their care. The correct care plan, along with assistive equipment and technology, was provided quickly to ensure a high quality of life was sustained for that person.
Care provider: Anonymous
Date published: April 2018
Regularly reviewing and reflecting
Each morning, office staff had a ‘huddle,’ which provided a chance to discuss the events of the day before and plan for the day ahead. On Monday mornings, senior office staff met to discuss the previous week’s concerns and plan for the week ahead.
Care provider: Anonymous
Date published: April 2018
Using reflective meetings to identify preventative measures
Following accidents and incidents, reflective meetings and staff meetings are held to discuss such matters and how to do things differently going forward. The team discuss preventative measures to avoid the same reoccurrence. Risks are reassessed and changes are made to care plans where necessary and cascaded to the team.
Accidents and incidents experienced in the setting are turned into scenarios and these are taken to group discussions or supervision sessions. They’re discussed and reflected on to see what can be learnt and if things could be done differently to achieve a better/different outcome. Using situations that have occurred in the setting makes it easier for staff to relate to, which makes the exercise more meaningful.
Read more abut this service here.
Care provider: Simply Care (UK) Ltd
Date published: April 2018
Meeting outcomes around planning for a good life
People’s care and support was planned proactively in partnership with them. Staff used inclusive and individual ways of involving people so that they felt consulted, empowered, listened to and valued.
The provider used the tool ‘My good life’ as a means of measuring people’s achievements. This tool was based on six outcomes: having friends and relationships, making choices – being in control, sharing my gifts and talents, sharing ordinary places, being respected for who I am, being healthy and staying safe.
In order to meet the outcomes listed in ‘My good life’, people were supported to complete the ‘big plan.’ During this process, people got together with their family, friends and staff to plan for a good life. People who used the provider’s services also joined in to undertake their big plans at the same time.
Care provider: Anonymous
Date published: April 2018
Linking in with ‘circles of care’
We invest a huge amount of time in ensuring that each client’s individual needs and health and social outcomes are being met. This involves the home carer directly, as well as our office-based care management team who spend many hours a day communicating with the client’s ‘circle of care’. This might include relatives, neighbours, GPs, district nurses, mental health teams, occupational therapists and physiotherapists. It also includes extensive quality assurance processes such as a consultation with the client’s GP at commencement of care, an initial review after the first four weeks, weekly support visits for live-in carers, formal reviews at least every six months, annual feedback questionnaires and ongoing monitoring of any concerns, events or issues.
Care provider: Anonymous
Date published: April 2018
How a new pet led to successful outcomes
This service supports a person who has a learning disability compounded by challenging behaviour. Prior to joining the service, the person was prescribed a combination of medication to help control her behaviours, but the side effects impacted on her ability to communicate effectively.
After extensive monitoring, observing and recording, the service found many of her activities made her anxious, yet she was comfortable in the presence of dogs. Initially they began introducing her to dogs owned by her staff team but then supported her to become a dog owner.
This was an amazing success and helped with communication, interaction, and relationships. She’s since become a volunteer dog walker at a local wildlife and dog rescue centre and helps the centre to find homes by distributing information. She’s been supported by the same staff team for years, no longer takes medication and is a valued member of society.
Read more about the service here.
Care provider: Castle Supported Living
Date published: April 2018
Using music, dance and singing to improve wellbeing
When caring for a person whose behaviour challenged as part of a 24-hour care package, the provider was concerned about delivering safe care to them in a kind and friendly way. The provider tried multiple strategies to promote a calm environment, eventually finding that music helped and enabled them to provide the care needed.
Music, dance and singing was then used to diffuse situations and improve the wellbeing of the person, helping staff to work in a safe environment and provide the personal care needed in a stress-free environment.
Care provider: Anonymous
Date published: April 2018
Receiving expert advice – occupational therapy
The service used the expertise of an occupational therapist (OT) in securing equipment to meet the person's changed needs. This included a specialist bed, a new hoist and adaptations to the shower.
Care provider: Anonymous
Date published: April 2018
Developing staff healthcare skills
To strengthen healthcare skills within the service, staff had to complete a level 3 qualification and then underwent a comprehensive structured programme to build and enhance clinical skills over a six-month programme. These new skills were only signed off when the care practitioner was confident and competent in their ability to complete them and an observation(s) had been completed.This enabled staff to effectively deliver tasks such as clinical observations, basic wound care, taking bloods, administration of medication, care planning and reviewing, risk assessing, care reviews with relatives, managing the shift for the registered nurse, verifying death and allocating, and supervising and mentoring staff.
Care provider: Anonymous
Date published: April 2018
Identifying changes in capacity
Effective training and the practical use of an aide memoire (in the form of a Mental Capacity Act 2005 wallet-sized resource) helped care workers to identify changes in people’s mental capacity and draw on senior carer expertise to support further.
Care provider: Midlands Care UK
Date published: April 2018
Improving understating of dementia to support health and wellbeing
A project from the London Borough of Havering brought together staff from across housing and adult social care services to develop their understanding and knowledge of dementia, and to help people with dementia to live well and be supported within their own home for longer. The aim was to help Havering residents sustain and maintain their tenancies, thus avoiding entering emergency or residential care.
The project successfully delivered three programmes of training to 75 frontline staff and 24 family members and carers. The staff developed their knowledge and understanding of the topic, were informed of the support available for carers and people who need care and support, and had the opportunity to discuss ways in which services can work in a more integrated way going forward.
The project identified a group of dementia champions across the services, helped them achieve the level 3 award in awareness of dementia, and supported them to develop a ‘tenancy sustainability tool’ which gathers information to help housing services staff and frontline workers to recognise people’s support needs and trigger conversations with social care staff at a much earlier stage.
Care provider: London Borough of Havering
Date published: December 2016
Strengthening care by developing health skills
St Monica Trust developed a new training programme involving senior carers to focus on the different needs within home care, in particular around clinical and mental health issues. To assist this process, they engaged with an expert clinical trainer to develop content that helped form workbooks.
Using a combination of taught workshops and workbooks ensured that staff learnt theory and applied practice, leading to formal assessment around areas including medication administration.
Participants in the training gained confidence around rights and choices for people with dementia. Their understanding of assistive technology has strengthened, as was their ability to provide more choice to the people they care for. Participants also gained better understanding, knowledge and awareness of malnutrition and dementia.
Click here to read the full case study.
Read more abut this service here.
Care provider: St Monica Trust
Date published: December 2014
Sporting memories
It wasn’t until the mid-1960s that reminiscence started being considered as a positive thing to do, but more and more evidence has emerged that it’s an incredibly healthy activity. It’s a great way to encourage people to share their stories across generations.
We hit upon the idea of using sport because there’s such a rich variety of resources available, but it’s a subject that men in particular naturally talk about. It’s a conversation that men are comfortable having most of their lives, and one that we aim to either continue having, or reignite for people who may be living with memory problems.
We’ve developed a number of training resources and materials for people to facilitate our groups. The way we work is to train staff and volunteers working in all aspects of social settings to start groups and facilitate effective sports reminiscence.
Click here to see the full video.
Care provider: Sporting Memories Network CIC
Date published: January 2014