J&C Healthcare 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.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of the legal regulation relating to safe care and treatment and consent.

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 provider system and processes for assessing and reviewing people’s health, care and wellbeing were not always up to date.

Care plans and risk assessments were not consistently reviewed. For example, one person assessed as high risk for skin damage had no evidence of a recent review. The management team acknowledged this and were taking action to address the issue.

Whilst we did not identify anyone who had come to harm, this contributed to the breach of regulation in relation to safe care and treatment.

A person told us, “When they (JC) first took over they went through everything and brought the carer with them, that was going to be looking after me. It was all very professional”. A staff member told us, “Any new client, we have all the information in the care plans, and we all do read them before we go into a client, and if we do have a question we can go or ring the office and ask."

The provider did not always plan care and treatment in a way that reflected what mattered to people.

One person’s care plan was not updated to reflect their dietary needs and required support. This care plan lacked guidance on managing and how best to support the person with a PEG (Percutaneous Endoscopic Gastrostomy), including the dietary regime prescribed by the dietitian. A relative told us “If carers don’t know how to clean the PEG or, how to deal with it the manager will come and show those carers what to do”.Some office staff had received PEG training to support staff.

Whilst we did not identify anyone who had come to harm, this contributed to the breach of regulation in relation to safe care and treatment.

People told us staff supported them in ways that met their needs and preferences. One relative told us, “The carers know that they have to cut mum’s food into small pieces as she is a choking risk, and then they sit with her until she has finished her meal. Sometimes they eat with her as they have their own lunch with them.”

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 needs when people moved between different services.

The service made timely referrals to medical professionals, including occupational therapists and St Luke’s who provide support to people with progressive life-limiting illnesses. A staff member told us, “We see a couple of DNs OTs (District nurses and Occupational therapists), we do communicate about clients, we talk to them about what is going on with the clients.” One professional told us, “They are very clear in cascading relevant information to me about what’s going wrong, what they are doing to try and resolve the situation, and what they have already tried.”

The provider supported people to manage their health and wellbeing to maximise their, independence, choice and control. Staff support people to live healthier lives and where possible, reduce their future needs for care and support.

The management team told us they supported people to make healthier choices by providing information about risks, while respecting each person’s right to make their own choice. A staff member told us, “If they say no to anything then it is a no, everything is their choice, but it is about making sure they understand and agree.”

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.

One person told us, “JC were allocated to me by social services, but they were so nice to me and very thorough. Their service has kept me living in my home.”

Records showed wounds were monitored and escalated to medical professionals when needed. However, wound management was not reflected in people’s care and support plans. We discussed this with the registered manager who was taking action to address this.

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

People’s records included a single mental capacity assessment that was not decision-specific. The provider was not consistently working in line with the Mental Capacity Act 2005.

Whilst we did not identify anyone who had come to harm, this contributed to the breach of regulation in relation to consent to care and treatment.

A relative told us, “I have heard carers asking mum for permission to do something, or sometimes they explain to her what it is they need to do and why”. Staff told us, they would gain consent before supporting the person. One staff member told us, “We always ask and get consent, definitely. I do it all the time, so it is just something you do without thinking about it.”