Belong at Home Domiciliary Care Agency - Wigan & Southport

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. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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.

Initially the provider completed an initial assessment of the person’s needs prior to them being accepted as a ‘customer’. Following this, a detailed needs assessment was completed by trained members of staff. The needs assessment reviewed all aspects of care which was required, including personal care.

People’s communication assessments were also detailed and reviewed people’s speech, hearing, sight, comprehension, expression and whether they had any issues with communicating over the telephone.

The electronic data system allowed staff to provide detailed handovers for other staff. When handovers were documented, other staff and leaders were notified. Leaders had oversight of these notifications and were able to monitor whether they had been read or responded to by the staff members who would be attending to the person.

The provider always 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. They worked to develop evidence-based good practice and standards.

Leaders were proactively learning about new and innovative evidence-based approaches which could improve service delivery. For example, person centred care planning placed the person at the centre of their treatment, using data to adapt care needs as they changed. Digital tools also allowed staff to provide real time feedback in which they could share observations and concerns which allowed leaders to respond quickly.

The registered manager played a key role in advancing best practice and leadership by actively engaging with other agencies. For example, they regularly drove discussions and shared insights at the ‘Skills for Care’ meetings.

The provider had established multiple ways of ensuring changes of legislation in best practice were communicated to staff and embedded in practice. For example, staff had a working group to discuss evidenced base care and treatment and how to implement this in their role.

The provider had a range of evidence-based information available for staff members to utilise including ‘10 top tips for supporting people with dementia’ which had been produced in conjunction with Dementia UK.

People’s nutrition and hydration needs were met in line with current guidance. People had detailed nutrition and hydration care records in place which detailed people’s dietary needs, preferred food and fluid intake, any risks of malnutrition and dehydration, and regular monitoring and review schedules.

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 provider had close relationships with teams and services locally. The registered manager evidenced how they had completed initial assessments with community matrons, explained how the team had good working relationships with district nurses, occupational therapists, the speech and language team and others.

The provider had access to GP connect which allowed staff to view important clinical information, such as past diagnoses, medication lists and allergies. Access to this also allowed timely information sharing between primary care and social care professionals.

Staff told us they mainly had contact with district nurses, and all explained having a very positive relationship with them.

The provider had employed Admiral Nurses, who were appointed in partnership with the national charity, Dementia UK. Admiral nurses are mental health nurses specialising in dementia care. They offer individualised support for family members, carers and people who have been medically diagnosed with any form of dementia. The service was freely available to Belong customers.

The provider also worked closely with relatives of people who they were supporting. The registered manager told us, how some of the relatives had responsibility for completing certain tasks as they may have had years of experience of supporting someone with this or this may be their preference. For example, one person supported their relative who was at risk of dysphagia with eating and drinking, although staff had the appropriate training if the person was to choke. A further person’s relative supported with carers for calls which meant they worked in partnership.

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 provider ensured that people receiving community care had the same opportunities to access facilities as those who were based in the provider’s ‘villages’ (Belong Care Villages are care homes in which people receive accommodation and nursing or personal care as a single package under a contractual agreement). Therefore, people could access the café’s and attend the events (including bingo/floral arranging and dining) which promoted social inclusion and led to people living healthier lives.

People had access to an award-winning exercise and rehabilitation service. People receiving homecare, could access the provider’s ‘villages’ with specialised gyms which were run by qualified exercise specialists with experience of working with older people. Gyms were adapted to support older people, with classes with a focus on falls prevention and promoting independence through exercise.

Staff were knowledgeable about the importance of supporting people with their health and wellbeing. A staff member explained how they supported people to attend gym sessions, encouraged them to eat well and regularly attended appointments with them. They said during personal care, if they were to identify anything which needed a referral externally such as issues with someone’s feet they would do so.

The provider evidenced, via daily notes and through photographs how people were encouraged and supported to make healthy and appetising meals.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

People’s outcomes who used the service were positive, consistent and regularly exceeded expectations.

The provider actively monitored outcomes via trends analysis. The registered manager demonstrated how the trends analysis had shown how there had been an increase in aggressive behaviours towards staff from a person whose dementia had progressed. The outcome was that a service review was completed with the person’s loved one’s and they agreed to an increase of 2 carers. They agreed to monitor the progress with this approach at the next service review.

The provider used structured assessment tools, which is a standardised method of gathering information about a person’s needs or risks regarding areas such as nutrition, mobility and other care tasks. Structured assessment tools supported staff and leaders with monitoring outcomes for people. We saw an example in which a person was scoring consistently high on the Waterlow assessment (used to identify a person’s risk of developing pressure ulcers) and how this was communicated with the relative who then made a referral to the nutritionist. A further person’s weight loss, body mass index (BMI) and reduced food intake was being monitored via the Malnutrition Universal Screening Tool (MUST), as well as depressive symptoms being monitored via the Cornel Depression Tool. The latter was used to inform discussions with the mental health team and GP.

Staff told us they monitored people’s outcomes via the electronic system which they used. They explained how they had opportunities to review the person’s recent observations and progress notes. They had access to alerts and handovers from other staff and leaders which informed them of any changes related to the person.

People’s outcomes were discussed within the service level reviews and if there were any issues these were discussed and addressed.

The operations manager spoke about how the provider had plans to build a more comprehensive outcomes section on the electronic system which was being used. This was currently being tested and was in the ‘beta stage’ but will clearly evidence goals, outcomes and progress towards these.

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

People understood their rights around consent to the care and treatment they were offered.

People's capacity and ability to consent was considered, and they, or a person lawfully acting on their behalf, were involved in planning, managing and reviewing their care and treatment.

People received information about care and treatment in a way they could understand and had appropriate support and time to make decisions.

Staff had a good knowledge of the mental capacity act and understood the importance of ensuring people fully understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment.