Blay Domiciliary Services

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 inspection 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.

The provider had made improvements to their assessment document and to their procedure for undertaking reviews to ensure effective care was developed for people to meet their individual needs. The provider implemented a robust pre-admission assessment to ensure people’s needs were identified and could be met. People, and where appropriate, their representatives, were involved in planned reviews which took place at regular intervals. For example, 4 weekly and 4, 8 and 12 monthly reviews were facilitated by staff who knew people well.

The provider completed quality monitoring audits of people’s care plan records. These identified areas for improvement and action plans were developed to achieve these. For example, when specialist equipment had been advised by a specialist, written confirmation of the request and implementation for this was identified as being required to be included in a person’s care records.

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. Regular reviews of care records completed by the provider captured what was important and mattered to people. People were supported by regular teams of staff who they got to know well. The teams of regular staff also knew people well; staff understood how best to communicate with people and support them in the way they preferred.

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. Systems utilised by the provider ensured up to date, accurate care records were kept. These records were shared with others when appropriate to do so. Staff were made aware of changes to people’s needs through effective communication facilitated by senior staff.

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 supported to develop and maintain their independence, choice and control. Staff understood their role to support people to manage their health and wellbeing. One member of staff told us, “I encourage people to take part in making decisions about their own health and safety, promoting independence while making sure support is there when needed”.

One relative told us, “Can`t fault the carers, they are never late and are lovely with my [relative], they [staff] talk to them and make them laugh. They [relative] can wash their own hands and face now (they couldn’t before), I know it`s not much to you, but it`s massive to them and us as they couldn’t before”.

The service worked with health professionals to provide people with access to healthcare services and support.

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 an effective system to optimise people’s care and treatment. Risk assessments and care plans were regularly reviewed and changes made to ensure information and guidance was up to date. For example, where a person’s needs had changed as their health condition progressed, this was documented through an updated risk assessment and care plan. Staff understood their responsibility to monitor people’s care and treatment. One member of staff told us, “I observe and monitor the individual’s physical and emotional wellbeing during each visit. This includes checking for any changes in their mobility, mood, skin condition, medication needs, or daily routines. I follow their care plan closely and document any concerns. If I notice changes or new risks, I report them to my senior, or the family, as appropriate.”

The provider did not always fully respect people’s rights when delivering care and treatment in line with legislation. During the assessment a completed mental capacity assessment was found to be in place for all people in receipt of services. This did not follow the principles and codes of conduct associated with the Mental Capacity Act 2005. This blanket approach implemented by the provider did not follow the guidance to complete decision specific capacity assessments where required.

The provider took on board the feedback provided during the assessment and responded by taking immediate action to demonstrate their understanding of their responsibilities to implement the principles of the Mental Capacity Act. The provider reviewed their policy and procedure to ensure guidance was to implement capacity assessments as required. The provider reviewed the document used to record capacity assessments to ensure detailed information was recorded to evidence the steps taken to support people to make decisions and where decisions were made in people’s best interest.

Staff demonstrated their understanding of the MCA principles associated with capacity. One member of staff told us, “I respect people’s choices and privacy, support their independence, and follow the Mental Capacity Act. If someone lacks capacity, decisions are made in their best interests, involving families and professionals”.