Rainbow 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

People had care and support plans that were personalised and reflected both their physical and mental health needs. Care plans were reviewed regularly and reflected a good understanding of people’s needs, including relevant assessments of people’s communication support and sensory needs. People had health actions plans and health passports which were used by health and social care professionals to support them in the way they needed. Staff understood the importance of promoting people’s independence. Staff knew about people’s capacity to make decisions through verbal or non-verbal means, and this was well documented. People were empowered to make their own decisions about their care and support.

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.

We visited 3 supported living projects and engaged with 6 people. We were able to speak with 4 people about their assessed needs. 3 people were positive, 2 told us their care plans accurately reflected their needs and 1 person told us they were happy with their care. One person was negative, and the service manager explained they had disengaged from support and plans were in place to address this. The Expert by Experience contacted people by phone and spoke with 4 people and 5 family members. They told us they were involved in assessments and people told us their needs were being met. Three family members expressed concerns about the impact on care of changes to the staff team. We discussed this with the registered manager and systems were in place to minimise any changes.

We discussed assessed needs with 9 support workers. They told us care plans were clear, up to date and accurately reflected people’s needs. Care plans were reviewed regularly, and changes were also made in response to change.

We received positive feedback from 1 local authority commissioner and 4 health and social care professionals. They told us some of the care packages were complex and people’s needs were being regularly reviewed and met appropriately.

We reviewed 3 care plans and focused on consent, person-centred care and the accessible information standard. Each care plan contained the required detail and provided clear guidance to staff. The care plans were complaint with the Mental Capacity Act and included information about people’s diagnosis and how this potentially impacted on their ability to make decisions or not. Guidance supported staff to on how to maximise people’s ability to make choices and decisions for themselves, where possible. The information was person-centred and outlined people’s communication needs. The Distress and Discomfort Assessment Tool (DisDAT) was implemented during the inspection for 2 people. The tool is intended to help identify distress cues in individuals who because of cognitive impairment or physical illness have severely limited communication.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.

We visited 3 supported living projects and engaged with 6 people. We were able to speak with 2 people about the support provided to manage their health needs. One person told us they were independent and managed their own and the second expressed no concerns about the support they received.

We reviewed 4 care plans to assess people’s access to healthcare. All 4 were supported appropriately. Each had a health action plan and an annual health checks and access to other health professionals as required. The care plans included a focus on diet and physical activity. Health passports were also in place. One person found engaging with health care professionals difficult. The service manager explained how health professionals, supported by staff, had made reasonable adjustments to support this person to access healthcare and attempts were ongoing.

We received positive feedback from 1 local authority commissioner and 4 health and social care professionals. They told us people were supported to access healthcare as required. No concerns were raised.

The registered manager shared health action plans for all 13 people in supported living. We reviewed a selection of these plans and found no concerns.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We visited 3 supported living projects and engaged with 6 people. We were able to speak with 2 people about their consent to care and treatment. Both confirmed staff asked for their consent before providing care. The Expert by Experience contacted people by phone and spoke to 4 people and 5 family members. 5 families responded and expressed no concerns about consent.

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 MCA 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. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). 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. We reviewed the MCA and Deprivation of liberty safeguards (DoLS) with the registered manager. They demonstrated a very good understanding and had the necessary experience. We spoke with 5 support workers onsite about their understanding of consent. They also demonstrated a good level of understanding.

We reviewed consent and decision making processes in 2 people's care plans. Both were person-centred and detailed and provided staff with the required guidance to support people. People who were able to had signed their care plans and given consent to their care arrangements. We saw evidence of best interest meetings where required. We reviewed the MCA policy. The service was compliant with the MCA.