Great Care Health 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 assessment we rated this key question good. At this assessment the rating is requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (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, while they discussed people’s needs with relatives, this did not always result in people’s care plans, risk assessments and daily care records containing clear information.

Care plans did not always contain relevant information about people’s health, mobility and safety needs to enable them to receive care or treatment which provided good outcomes. For example, where people had identified health and mobility needs, they did not always have a care plan or assessment which adequately provided guidance to staff on how they could support people to meet these needs. This meant people were at risk of their needs not being clearly known and delivered by staff.

The review of care plans did not involve people and relatives once people had started receiving support from the provider. However, people and relatives were involved in the care planning process during the transition of people receiving support from the service.

The provider did not always plan and deliver people’s care and treatment, in a way which was important to them.

Care records were not always in-line with evidence-based good practice guidance. The information within people’s care plans made some reference to being based on guidance from external healthcare professionals. Where safety incidents occurred which might have justified assessment and guidance from external healthcare professionals, this support was not always sought. This meant people were at risk of their care and treatment not being delivered to them in ways which reflected their identified needs.

Staff understood people’s preferences, including how they asked for food and drinks, and relatives said staff supported their relative to access amenities within their communities.

The provider did not always work well across teams to support people.

Staff meetings did not take place on a regular basis. However, most staff, people and relatives told us they had no concerns with the communication they had with the provider.

While the service worked in consultation with some external services, opportunities for greater multidisciplinary working were sometimes missed.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control.

People’s care records did not always contain relevant information needed to ensure people could be supported to positively manage their health and wellbeing. We found information relating to people’s health conditions and needs did not always contain the guidance staff needed so they could support people to live healthy lives. For example, people living with health conditions, which affected how they were able to mobilise, did not have a care plan in place which directed staff how to support them. This meant people were at risk of their health needs not always being met.

Staff had not received training relevant to some people’s health needs, and some staff did not have an awareness of the health conditions people had nor how these affected them. However, staff demonstrated an awareness of the practical support they provided people based on some aspects of their health needs. For example, staff told us how they supported people with their eating and drinking needs which mitigated risks associated with this. This was supported by the feedback we received from people and relatives.

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.

People’s care records were not regularly and effectively monitored and reviewed by the provider. With an absence of effective care plan and safety events audits, the provider was unaware of the concerns we identified regarding the lack of relevant information in people’s care records and people’s care and health outcomes. This meant there was a risk the care and treatment people received from staff may not always meet their needs.

While this was not carried out on a consistent basis, people’s care was monitored by the provider undertaking visits of people’s homes and telephone calls to people and relatives to assess staff practice and to seek people’s and relative’s feedback.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider did not always consider the Mental Capacity Act 2005 (MCA) when supporting people. The MCA provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When people lack mental capacity to make particular decisions, any decisions made on their behalf must be in their best interests and as least restrictive as possible.

People judged as having the mental capacity to consent to their care arrangements had not always been supported to do so. Decision-specific mental capacity assessments and best interest decisions were not in place for people identified as lacking capacity. This meant people were at risk of their human rights not being respected.

Staff training records showed staff received MCA training; and people and relative feedback demonstrated staff had a basic awareness of the principles of the MCA, with 1 person telling us, “They ask me what I want before doing anything.”