APT Care Central Bedfordshire & Bedford

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 – 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.

At our last assessment we rated this key question Requires improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.
 

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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Assessments were completed before people received care and reviewed when needs changed. These included health, wellbeing, risks and communication needs, with tailored information to support safe and effective care. Communication needs were considered, with adapted methods used to support understanding.

Staff demonstrated a clear understanding of people’s needs and how to use care plans to deliver consistent care. One staff member said, “Yes, I take time to read and understand care plans and risk assessments properly so I can provide safe, person-centred care.” Another said, “Care plans explain the person’s needs, preferences, routines, and support required, so I can give consistent care.”

Professionals told us care planning was accurate and responsive. One professional said, “Coordinators regularly communicate with us to request adjustments to care packages, ensuring support is increased or reduced in line with need.” This showed people’s needs were reviewed and adjusted appropriately.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff demonstrated a good awareness of people’s health and dietary needs and followed professional guidance. One staff member said, “I follow care plans and professional guidance carefully, including dietary requirements, diabetic monitoring, food textures, thickened fluids, and SALT (speech and language therapy) recommendations. I encourage healthy eating, monitor food and fluid intake where required, and report any concerns such as poor appetite or swallowing difficulties.”

Care plans contained clear information about people’s dietary needs, preferences and allergies. For example, guidance was recorded for people living with diabetes and allergies were clearly highlighted. People were offered choice and supported with eating and drinking where needed. Feedback included examples of staff encouraging people to eat when their appetite was low and providing support with meals, which relatives valued.

Staff monitored people’s health and well-being and took appropriate action when concerns arose, including reporting changes in appetite or signs of deterioration.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider worked in partnership with health and social care professionals, including GPs, district nurses, social workers and therapists. Referrals were made promptly when additional support was required, which supported coordinated and responsive care.

Staff described effective communication and joint working. One staff member said, “I communicate professionally with nurses, doctors, social workers, therapists, and families to ensure consistent and person-centred care.” Staff also shared information internally through care notes, handovers and direct communication, ensuring changes in people’s needs were recognised and acted upon.

Professionals confirmed the provider worked well with others. One noted, “The information we provide is used effectively to accurately update clients’ care plans, ensuring continuity of care following hospital discharge.”

The provider supported people to manage their health and well-being to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People told us staff responded promptly to changes in their health. One person said, “My relative once had a sore arm and the carers were quick to respond to me and informed the doctor.” Another said, “We had an issue when my relative had a pressure sore on his foot, but the carers were on the ball with that.” This showed concerns were recognised and acted on.

Staff monitored people’s well-being and took preventative action, such as encouraging fluids and repositioning to reduce risks. They escalated concerns to healthcare professionals when needed.

Staff demonstrated a clear understanding of how to identify and respond to health needs. One staff member said, “I observe for signs such as confusion, pain, changes in urine, reduced mobility, redness on the skin, poor appetite, or changes in behaviour. I report concerns promptly and follow guidance to prevent further complications.”

The provider did not consistently demonstrate how people’s care and treatment were monitored to improve outcomes. Records did not always clearly show how assessed needs, identified risks and planned interventions were monitored over time or how outcomes were achieved in line with clinical guidance and people’s preferences.

Records showed people’s needs were assessed and guidance was in place, for example about supporting people to eat and monitoring food intake. Staff recorded visits in daily notes, but these did not always clearly demonstrate how care followed guidance within care plans and risk assessments or how progress was monitored over time.

For one person, records did not consistently demonstrate how food intake was being monitored over time, despite ongoing monitoring being required. Daily records showed food was sometimes declined but did not always clearly explain the reasons for this or reflect the person's preferences and choices. The provider confirmed the person had maintained a stable weight, remained well and had no identified health concerns.

We also identified one example where daily records did not clearly reflect risks identified within a person's assessment or demonstrate how these were being monitored. Discussion with the provider showed the person's needs had improved and the level of risk had reduced, but this was not clearly evidenced within the records.

Although outcomes for both people remained positive, the provider acknowledged the need to strengthen recording. System improvements were also planned to support clearer recording and earlier identification of risks.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff demonstrated a good understanding of consent and the Mental Capacity Act. One staff member said, “I assume capacity unless assessed otherwise and support people to make decisions by explaining information clearly.” Staff also described how they respected people’s right to make choices, including unwise decisions, while balancing safety and independence.

Records showed people were asked for consent before care was provided. This was supported through care records and feedback from people. Where people lacked capacity, decision specific mental capacity assessments were completed. These reflected the principles of the Mental Capacity Act, including assessing understanding, retention, weighing and communication, with clear outcomes recorded.

Assessments showed staff took appropriate steps to support people to make decisions, including using simple language, repetition and involving family members. Where people lacked capacity, best interest decisions were made with involvement from family and others, including those with legal authority.