Hand of Hope Homecare Services 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.

This is the first assessment for this 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.

The service was in breach of legal regulation in relation to need for 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People and relatives told us they had a care plan. One person told us their, “care plan is due for review next week” and one relative told us the care plan for their loved one was completed two months ago and was, “fully tailored to [person] needs”,

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We reviewed care records of people who had a diagnosis of diabetes. The care records did not include information on the type of diabetes the person was diagnosed with. There was no guidance recorded within these care records to support staff to identify signs and symptoms that may impact negatively on people’s health diagnosed with diabetes. This put people at risk of staff not understanding the signs and symptoms of hypoglycaemia or hyperglycaemia (Sugar levels being too low or too high) as staff did not have the relevant information recorded. The registered manager did not demonstrate their understanding of delivering evidence based care and treatment.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. The registered manager told us they discussed any internal issues in supervisions and they, “have to work as a team”. However, professionals told us the provider had not always been transparent in relation to sharing information.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Care records did not show how people were being supported to improve their health and well-being, for example, with their mobility and communication. In one person’s care records, the guidance for staff was to, ‘make [person] sit on the commode and change [person] pad when needed’. This did not include how the person informed staff if it was needed nor did the daily notes show if the person was asked and how they were subsequently supported.

This did not demonstrate the provider was supporting people to manage their health and well-being in a person-centred way so they could maximise their independence, choice and control.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. The daily notes did not evidence people were supported to raise any concerns regarding their health nor engage in any conversation regarding their care and treatment. For example, some daily notes were repeated, and some notes were recorded as ‘[person] is fine’ and ‘had chat.’ This did not evidence people’s health was routinely monitored.

The provider did not always tell people about their rights around consent or respect these when delivering care and treatment. The registered manager informed us they were told by a local authority to action capacity assessments for “every client” as it was “good practice” and they were going to do mental capacity assessments for people without capacity issues. We were not assured the provider understood their responsibility in relation to conducting mental capacity assessments. The mental capacity Act 2005 states, assume a person has the capacity to make a decision themselves, unless it's proved otherwise. Capacity assessments should be completed if at the time the person is unable to make a decision for themself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain.

Care records guided staff to ask for consent from people before assisting with care tasks. Whilst people and relatives told us consent was obtained, the daily notes did not evidence consent was obtained. Mental capacity assessments were not decision and time specific and did not demonstrate the person was included. For one person’s mental capacity assessment, it was unclear why the support of a translator was required when this form stated the person was able to communicate in English. We informed the registered manager to review the mental capacity act guidance.