Josh's Care Company 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 good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

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

The provider ensured a comprehensive assessment of needs was completed with each person before the care package was agreed. This ensured the provider could support the person to manage their needs safely. The provider developed bespoke packages of care for each person. The talent acquisition team worked with the person to develop a job description and person specification to match their needs as closely as possible. The person was offered the opportunity to meet with staff to assess if they believed the person to be a fit for them and their care package. The focus of the team was to find the right staff to support the person. One relative told us, “The staff team is reliable. I do not worry, they know [my relative] well. Staff are friendly and keep [my relative] safe”.

The training team worked with the person and others involved in their care to identify the knowledge and skills required by the staff supporting them. All staff went through a company induction programme which consisted of face-to-face training and assessment, enhanced by online e-learning. Staff were then trained to ensure they had the necessary knowledge, skills and competence to work with each individual person. Staff from the provider training team worked with each person to ensure they were happy with each staff member allocated to work with them. One person told us, “Staff are trained expertly and know how to keep me safe”.

People were involved in ongoing reviews of their health, care, wellbeing and communication needs. Core staff teams were involved in all reviews as well as people’s representatives, families and professionals involved in their care. One person told us, “The nurse leads on catheter care and supports care staff as needed.”

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.

The provider worked with each person and their family or representative to set up teams of care staff to support them. People were confident their staff knew them well and treated them with dignity and respect. One person told us, “I am the centre of everything they [staff] do.” Another person told us, “They [staff] always respect my dignity, they [staff] communicate with me in the way I prefer.”

Area nurse managers worked with professionals to ensure consistently good care and support was provided by staff to protect people’s rights and promote their wellbeing. Care was delivered by staff who consistently demonstrated their understanding of the importance of person-centred care. One person told us, “Staff are always willing to learn, they [staff] are well trained, and I feel exceptionally safe with them. I am treated with dignity and respect; staff communicate with me and my family. Staff do things how we like them to be done”.

Nurses arranged multi-disciplinary meetings in response to identified changes in people’s needs to review and plan the most appropriate care for people. Staff were involved in helping to identify ways to improve outcomes for people. People received clinical care and support in line with evidence based good practice and standards. For example, nationally recognised assessments of need were used to inform guidance for staff to safely meet people’s nutrition needs and identify the risk of developing pressure ulcers. Specialist advice and support was sought where appropriate to meet people’s needs safely. One professional told us, “I supported specialist training for a very complex care need.”

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 implemented robust care record systems, including needs assessments and reviews, which were accessible to people and their staff teams. Up to date records were shared with relevant professionals as required. Staff understood their responsibilities in partnership working with people’s families, professionals and other care agencies, where a person was receiving support from different agencies.

People’s electronic care records were kept up to date. Staff had a clear understanding of different roles and responsibilities; information was shared with other professionals in a timely way.

The provider planned support for people to transfer between services. For example, one relative described to us how the provider facilitated the change from children to adult services for their family member. A relative told us, “The transition was seamless, the care carried on.”

The provider supported people to manage their health and wellbeing 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 were encouraged and supported to manage their own health, care and wellbeing needs wherever they could. Staff knew people well and understood their needs and preferences. Staff understood how to monitor people’s health closely and knew to report any concerns immediately to the office or emergency services, depending on the individual situation.

One person described to us the improvement in their level of independence since being in receipt of effective care and the positive impact on their family who no longer had to worry about them and could pursue their own activities whilst their loved one was being helped to keep safe.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider implemented quality monitoring systems to ensure people’s care and support was effective. Monthly audits of care records, spot checks by senior staff and obtaining feedback from people gave opportunities for the provider to identify where improvements to care and support could be made. Actions were planned and monitored to achieve these improvements.

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

People were supported to consent to their care, support and treatment where they had capacity to do so, and the principles of the Mental Capacity Action 2005 (MCA) were followed when people lacked capacity to make decisions about their care. Staff understood about making sure people were truly involved in making choices. For example, one member of staff described how a person they supported communicated through eye pointing and how they supported the person to make decisions considering their preferred way of making their wishes known.