London Care (Rochester)

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 requires improvement. At this assessment the rating has remained 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 person centred care. Care plans were not person-centred to show how people’s health and emotional needs would be met.

This service scored 62 (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 make sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Care records contained information about people’s physical and mental health condition, personal care, medication, nutritional and skin care needs. However, information about people’s needs were not comprehensive and detailed to ensure staff knew how to support people’s needs to keep them healthy and safe. For example, two care records stated the people had a learning disability. The Right support, right care, right culture (RSRCRC) model should be used when assessing the needs of people with learning disabilities. However, no details had been provided on the nature or type of learning disability they had, how it impacted on them, and how they should be supported to maximise their well-being. As already stated, we also found that some people’s care needs assessments did not provide sufficient details about their physical health conditions and how they needed to be supported to keep them safe and well.

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.

People were supported with their nutritional needs. One person told us, “They make me some cereal or toast for breakfast and at lunchtime they reheat a meal for me and leave me with a drink. I tell them what I want.” Care plans detailed what support people needed to shop for food, prepare their meals and if they had any special diets or nutritional requirements. One person was supported to have fortified drinks. Staff told us if they had concerns with people’s eating and drinking, they reported this to their manager so that appropriate support would be provided. Staff told us they left water within reach for people and encouraged them to drink especially during hot weather.

Staff were trained and supported to recognise concerns with people’s nutrition and how to support them appropriately.

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.

Staff liaised and shared information about people, their relatives where appropriate and other agencies involved in the person’s care. For example, if people needed to go to hospital, they gave them a copy of their care plan or care passport which contained important information about them.

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 access a range of health and social care services as needed. Records showed a range of health and social care services were involved to maintain people’s health and well-being. For example, staff had contact details for community nurses who looked after people’s catheter. Staff told us they contacted people’s GP if they needed support to arrange medical appointments.

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 manager told us they used monitoring visits and reviews to assess the outcome people received from the care provided to improve their experience. However, people told their monitoring checks did not always improve outcomes for them. One person told us, “Every now and then I might get a phone call asking about what I think of the carers. But they are very brief questions, and nothing ever improves with my feedback. I have mentioned to them about informing me when they change my regular carer or when they change the times, but it hasn't really improved.”

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

People consented to their care and support before it was delivered. The manager understood their roles and responsibilities under the Mental Capacity Act 2005 (MCA). They had assessed people’s mental capacity to make specific decisions where they had concerns about the person’s capacity.

People’s capacity was documented in their care plans. Where they received support to make decisions it was also documented and who supported them with such decisions. Where people had Court of Protection orders or lasting powers of attorney, they were noted in their care plans.

Staff had received training in MCA, and they knew the importance of gaining people’s consent in relation to the care and support they received.