Eunha Healthcare 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 – 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 remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to capacity and consent.

This service scored 54 (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 make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People’s needs were not comprehensively assessed and did not always include consideration of all of their needs. We identified a number of care plans which lacked detail, and risk assessments which had not been completed, despite the provider knowing of certain risks at the commencement of people’s packages of care. This meant staff did not have all of the necessary information to enable them to support people effectively from the beginning of their care package. For example, a person with specific health risks had not got a robust risk assessment in place to guide staff, until we raised this, which was 4 months after the package of care had commenced.

Whilst the leadership team could describe the process they would follow when a new package of care had been commissioned, we found that this was not always adhered to. For example, completing risk assessments in a timely manner. We saw a person who required a specific continence risk assessment; however, this was not completed until 6 weeks after the start of the person’s care package. Despite not having the risk assessment in place, staff were aware of how to meet the person’s needs and were managing the risk.

There was also limited evidence that people’s voice had been captured in the care planning process. These concerns were shared with the provider, who began updating a number of records for people and ensuring people’s voice was included. The provider sent us evidence of improved documentation immediately following our feedback.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Nationally recognised tools were not used to help inform care planning and outcomes for people. Where people had already been identified as being at increased risk of skin breakdown, Waterlow scores (a calculation which helps care providers estimate the risk of a person experiencing a pressure sore) had not been completed. MUST (a tool to help care provider’s identify people at risk of malnutrition or obesity) had not been completed, which meant staff could not effectively understand people’s specific needs to enable them to deliver the best possible care. However, staff did know how to recognise and raise concerns in relation to weight and skin issues.

We identified a person who had required a modified diet, however, an error had occurred and the incorrect food level had been recorded in their care plan. This meant staff did not have the right information available to them to support the person in the most effective way. We addressed this with the provider who acknowledged the error and immediately updated the person’s care plan. No harm had come to the person as a result of this error.

Most people and relatives told us they felt staff were competent to deliver care, however some feedback highlighted concerns with the capabilities of some members of staff with one stating staff could not always prepare food.

The provider mostly 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.

We identified 1 person who required a hospital passport (a document to help paramedics and hospital staff understand a person’s needs); however, the document we were sent by the provider did not contain enough information about the person’s current health, care, wellbeing or communication needs.

People spoke positively about the information sharing between the care provider and external health professionals. One relative told us, “The carer’s management team liaise with the OT (Occupational Therapist). I liaise with the district nurse. Recently, the carers management contacted the OT to get a hospital bed. They have been very good.”

Where people had been discharged from a stay in hospital, feedback on the transition back to receiving care from the provider was positive. One relative explained, “[Loved one] has had a few admissions. The hospital liaises with the service. When [loved one] is discharged, the carers are there the same day.”

Feedback from an Occupational Therapist was positive. They said, “Eunha are a pleasure to work with, and as mentioned have Excellent communication with myself and other Multidisciplinary members. Eunha carer’s are also willing to accept and embrace positive change, which as a result of this provides the best practice for clients, and the carer’s themselves.”

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

Feedback from people and their relatives was mainly positive. People told us they were encouraged to be independent, and we saw some evidence of people being encouraged to participate in tasks within the daily notes made by staff.

Staff supported people to a range of medical appointments when required.

Most relatives felt they were informed when their loved one’s health deteriorated or medical intervention such as a GP was required. One relative explained, “Yes[staff]have[kept me updated].One instance was when[loved one]had to[seek medical attention].Also, they let me know about the rash on[loved one’s]head. They alert me that[loved one]is finding it more difficult to get out of the chair in the living room.”

Staff understood when to seek medical attention for people, with one relative advising, “[Loved one] had a fall last Monday, the staff phoned the office and arranged for a paramedic in a car to come and check [them] out at the hospital, all instigated by the carer.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it.

There was a lack of evidence to show staff and leaders helped people understand and agree what good outcomes looked like for them.

Whilst some people did experience positive outcomes, this was found to not be the case for all people using the service.

Nationally recognised monitoring tools were not implemented at the service, charts to identify themes and trends in people’s distress were not used, and care records lacked detail on the monitoring required by staff for specific health conditions.

One person had been identified as requiring a Health Action Plan(a document that details a person's specific health needs, goals, and the steps to achieve them), however this was not observed to be in their care records during the inspection.

The provider did not operate within the Mental Capacity Act 2005 and the associated codes of practice.

We identified a blanket approach to the completion of mental capacity assessments, which included assessments being completed for people who did not have cognitive impairment, and the same decisions being assessed for all people using the service, even when these were not applicable to the person in question.

Mental capacity assessments were not decision specific. A number of people had been deemed to lack capacity, and best interest decisions had not been completed.

The registered manager was not clear on their responsibilities in relation to ensuring appropriate decision-making processes were followed. We also could not be assured the provider was following their own policy in relation to capacity and consent.

Staff told us they had received training in this area, we were not assured these were effective as staff had not raised concerns to the provider about the mental capacity assessments in people’s care plans being incorrect.

Staff did understand they needed to seek consent prior to delivering care, with 1 staff member explaining, “You ask for their consent even for personal care. Even ask consent for medication.” However, it was not clear how staff would proceed for people who had been properly assessed as lacking capacity in some areas of their care and support.