Real Social Care Solutions Ltd

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

Effective

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always ensure people’s care and treatment were effective, as they did not consistently check and discuss people’s health, care, wellbeing, and communication needs with them.

We received mixed feedback about people’s involvement in the assessment and of their care and support needs. One person told us, “I don’t know anything about care plan reviews.” Another person said, “There have been some care plan reviews, and the boss has come to the house to do those.” Records did not consistently demonstrate when care plans had been reviewed or who had been involved. This meant there was a risk that care was not regularly reviewed or updated to reflect people’s current needs and preferences, impacting the effectiveness of care provided. The registered manager took immediate action and told us they would review all care plans and ensure people were provided with the opportunity to review they care to ensure it was effective.

The provider did not always plan and deliver people’s care and treatment in partnership with them, including what was important to them and what mattered most in their daily lives.

As identified within the Safe section of this report, the provider did not consistently ensure care and support was delivered in line with best practice guidance for medicines management, risk management, and person-centred care. This meant there was a risk that people’s care was not tailored to their needs and preferences, and may not have been delivered in a safe, effective, or person-centred way.

The provider worked well across teams and services to support people. Whilst records sometimes lacked detail and guidance, people and their relatives told us that teams worked effectively together to ensure care was provided. One relative shared, “The district nurse comes fortnightly to test blood, give him an injection, weigh him, and check his blood pressure. I have seen the carers looking at the notes after she has been, and if they spot anything that needs checking, they liaise with the surgery, sometimes through me.” These comments demonstrated positive multidisciplinary working in practice, ensuring people’s needs were monitored and responded to appropriately.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

People and relatives told us staff supported them and knew them well to ensure they could identify any concerns or risks. One person told us, “Regular checks are made for sores and rashes and if anything is found, they liaise with the District Nurse or GP and organise antibiotics.” This meant staff supported people to live healthier lives and where possible, reduce their future needs for care and support

The provider did not always routinely monitor people’s care and treatment to drive continuous improvement. They did not consistently ensure outcomes were positive, consistent, or met both clinical expectations and the expectations of people themselves.

Effective systems were not always in place to review care and support. Daily notes were not regularly audited, and care plans were not consistently reviewed. Therefore, we could not be assured that care was being effectively monitored or that risks were identified and addressed to improve outcomes for people. This meant there was a risk changes in people’s needs were not identified in a timely way, impacting the quality and safety of care provided.

The provider did not always ensure people were informed about their rights in relation to consent or that these rights were consistently respected when delivering care and treatment.

Although staff demonstrated a good understanding of the need to obtain consent, the provider could not show how they had applied the principles of the Mental Capacity Act 2005 in practice. Care records did not clearly evidence whether people had consented to their care. Where people may have lacked capacity, there was no clear record of mental capacity assessments or best interests decisions being carried out. This meant there was a risk that people’s rights were not fully upheld, and care may not always have been delivered in line with legal requirements and best practice.