On Time Care Ltd

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• 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.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people’s care and treatment were effective. They did not always ensure when people’s needs changed, guidance was up to date, and their changing needs were understood and supported by all staff.

One person had a care plan in place, related to the consistency their food should be served at, however, staff were not following the guidance in the plan. We spoke with the provider about this, they told us the plan did not contain the up-to-date information, which was now in place, however, staff were following the most recent guidance in practice.

One person had a diagnosis of dementia. Their care plan did not detail how the persons dementia presented and what action should be taken to support them when they became confused. Staff were able to tell us how they support people during times of distress.

The registered manager told us, they would update these documents to ensure they contained the relevant information.

Staff told us people’s views were sought using their preferred communication methods across various platforms including, during daily support and in review meetings.

People and those who knew them well were involved in their assessments and reviews. Where people could not participate or chose not to staff and those who knew people well were also involved to ensure their views and opinions were captured.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, this was not always in line with legislation and current evidence-based good practice and standards.

People’s care and support relating to their agitation and associated behaviour were not planned in accordance with nationally recognised positive behaviour support guidance Staff monitored people’s weight if required and used nationally recognised tools appropriately to assess and monitor people’s needs. For example, Malnutrition Universal Screening Tool (MUST) and a clinical tool used to evaluate a person’s risk of developing a pressure ulcer (Waterlow assessment) were undertaken.

Staff ensured people had enough to eat and drink and people were supported to maintain relationships with family and friends.

The service 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 sought feedback from professional’s who worked closely with the service. A professional told us, “On Time Care Ltd work well with other health professionals. They provide at least one update a week as to the person’s presentation and what activities they have participated in.They seek guidance when they are unsure or when they would like to introduce something new.They are polite and professional in all interactions.”

People’s goals, dreams and aspirations were discussed with them and always communicated so a consistent approach was maintained between services.

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

The service did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

One person’s PBS plan detailed they may become agitated when they were in pain. However, the plan did not detail how the person may present when they are in pain or what action staff should take. Therefore, staff may not always identify when the person was becoming unwell so that appropriate medical intervention could be sought or concerns communicated to relatives.

We spoke with the registered manager about this, they assured us they would update the person’s PBS to include this information.

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

Review meetings took place with people to understand their goals and aspirations. However, the lack of detail in relation to for example, behaviour support meant people and their relatives could not always provide feedback on all aspects of people’s support to ensure care outcomes were positive and consistent, and met the expectations of people.

People were engaged to ensure they were able to make some choices about their lives.

The service told people about their rights around consent and respected their rights when delivering care and treatment.

Staff understood the importance of asking for consent prior to providing care and support. They told us they always sought consent from people before entering their rooms and they explained what they needed to do to support the person safely, before seeking their consent again.