Hales Group Limited - Waveney

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.

This is the first assessment for this service. This key question has been rated Good. This meant people’s outcomes were consistently good.

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 could improve systems to ensure people’s care was effective. Whilst people’s needs were assessed and included consideration of their physical, mental health, sensory, social and communication needs, we found the information was not always sufficiently detailed. The quality of the daily records written by staff also varied. Having clear, detailed daily care records helps to support reviews or monitor for changes. The management team had already identified this as an area for improvement via their auditing processes and arranged record keeping training for all staff. Risks to people were assessed, however, the use of standardised assessment tools which identify risks such as the development of pressure ulcers, or malnutrition, were not in place. This would further support the service to identify any concerns earlier and guide staff to take the correct actions.

Before people started using the service there was an assessment of their needs and choices to ensure these could be met. Most people and their relatives told us they were involved in these decisions and discussions. One person told us, “[Hales] started after [another provider] packed up. The transition went fairly well with Hales coming to agree a care plan [with me].”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, nationally recognised assessment tools were not currently being used to assess and monitor people’s needs. Assessment tools help to identify potential risks earlier in the care planning process. We saw people were asked what mattered most to them, such as maintaining a level of independence with daily living tasks, and records showed this was supported by staff.

People were supported to eat and drink to prevent malnutrition or dehydration and were supported by staff to manage their dietary needs and associated risks where needed. Improved recording of people’s food and fluid intake was required, particularly where people had a diabetic or specialist diet. Some people felt that further training was needed by some staff when preparing food. One person told us, “They [care staff] don't always listen and I am trying to teach them. They are supposed to cook but can’t do [specific food] in a microwave.” Another said, “You have to remind staff to cover food before they put it into the fridge, it’s the little things.” Staff received training in hydration, nutrition, and food safety.

The provider worked well across teams and services to support people. They worked with a wide range of health and care professionals. A social care professional told us, “I have found [registered manager] to be very responsive and proactive. Communication has not been an issue, and [they are] always happy to joint visit if there are issues to discuss.” Staff described better communication following the arrival of the new manager, and staff said they now received more effective guidance and support. People’s care plans included an ‘about me’ document which identified important information about people, such as what was important to them, and how they communicated. The level of detail in these documents varied, but the management team were in the process of updating these.

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 accessed health and social care when they needed it. The majority of people we spoke with told us that staff get them the right help when need it. We saw other professionals such as speech and language therapists, social workers, and specialist services, were involved in people’s care where required. People’s daily records showed they were supported by staff to maintain levels of independence in their daily living tasks.

The provider routinely monitored people’s care and treatment. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The registered manager understood the expectations people and their relatives had about the care they received and what positive outcomes look like for them. They were focussed on improving people’s experience of their care and intended to contact people on a more frequent basis to ensure any issues were resolved promptly. Audits being undertaken were identifying where improvements were needed, and from this we saw the quality of recording was improving. This included in people’s medicines records and the daily notes that staff wrote. The provider used a combination of digital tools, such as real time tracking logs and manual audits to monitor progress against people’s outcomes month to month.  People accessed healthcare services for their physical and mental wellbeing. The service did seek and follow advice from professionals and stakeholders as appropriate when monitoring individual outcomes.

The provider told people about their rights around consent and respected these when delivering person-centred care. At the time of the inspection, there were no people assessed as lacking capacity to make decisions. Care plans did however contain documents that showed people’s capacity was considered in relation to the care delivered. Further work was underway to ensure people’s views and what was important to them was more fully described in the ‘about me’ section of the care plans. Where Lasting Power of Attorney (LPA) was in place, this was documented. People told us staff always asked permission before assisting them. One person said, “The carer’s do ask me what I need before they do anything, and they are always polite.” Staff received training in the Mental Capacity Act 2005 and mental health conditions.