Indiana Health Care 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 has remained Good.This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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.

Each person had a care plan in place and people reported they had a copy in their home. The care plans were thorough, recording all aspects of peoples' needs. Where people had complex needs the care planning was detailed, covering for example, use of equipment to aid mobility, and medication where the service was responsible for the administration of a person’s medication.

The provider planned and delivered peoples' 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.

Staff ensured people had access to nutritious food which reflected peoples' preferences. One person commented on how they enjoyed learning and experiencing food from the staff members cultural background as well as their own saying, “I just love it”.

In addition to the contracted tasks staff had provided more care. For example, they had prepared food for a person’s carer because they were so tired from lack of sleep.

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.

The service was holding handover meetings and team meetings amongst the staff to ensure changes in peoples' needs and circumstances were communicated to all the staff delivering each person’s care. The service worked effectively with health and social care professionals involved in each person’s care.

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.

The service routinely contacted peoples' GPs on their behalf even though this was not part of the commissioned service. One person said, “As I have no family support, they are very kind, caring and are here for me and will contact the doctor”. Often staff were also the main contact with the GP and pharmacy system so peoples' routine medications were reordered, obtained and taken from the pharmacy to the person’s home by the services’ staff.

The provider did not always routinely monitor peoples' care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The service had recognised their monitoring IT system was not providing the information they needed to monitor and audit the delivery of the service effectively. For example, there were areas of care assessment and care planning that required better oversight, such as monitoring of restrictions imposed on people who did not have capacity to agree to those restrictions. We were told the new IT system would address the monitoring and oversight of these issues.

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 told us they were asked to give consent by staff to each of their personal care tasks.

The service had Mental Capacity Act 2005 policy and procedures in place and knew their content. However, at our first inspection visit we found 2 people were restricted within their own homes without a community Deprivation of Liberty Safeguard (DoLS) in place. The management of the service had not recognised the potential need for a community DoLS, and mental capacity assessments to assess if people were able to consent to the restrictionswere not in place.

When we returned for our second visit actions had been taken and an assessment for one person was being undertaken by the Local Authority.