1-2-1 Live In Care Ltd

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

People received care that was based on their assessed individual needs.

People's outcomes were consistently good, and people's feedback confirmed this.

Improvements were required to ensure care documentation was updated swiftly when needs changed to ensure all staff were provided with robust and up to date information related to people’s care and support needs.

Improvements were also required to ensure the service assessed the care and support in accordance with recognised assessment tools and guidance.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had an understanding of when the principles of the Mental Capacity Act should be applied, however some improvement were needed in relation to the consistency in implementing systems of gaining consent to ensure the service sought this from people when they started receiving care from the service.

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.

People and their relatives did not share any concerns in relation to how their needs had been assessed. One family member confirmed that they were fully involved in care planning and that this had just been updated. Another family member told us that “they (the service) go through it quite often especially as it is evolving.”

The deputy manager explained to us that as part of the pre-assessment process they completed the assessment form with the person and any family members identified by the person. This included daily routines, care needs and finding out what the person wished the carers do for them. The care documentation was reviewed after 10 days from the start of the package then periodically or sooner if needs changed. They also explained that a matching staff form is filled in with the client to ensure they provide them with a suitable carer as per their needs and requirements.

Staff were aware of actions to take if they observed people’s needs changed and they provided a weekly update to the management team which included any changes to people’s care and support, for example following involvement from healthcare professionals.

There was a system in place for assessments to be carried out before people began to use the service to ensure the service could meet their care and support needs. When carers were changing, there was a handover process in place to ensure information was passed onto the carer taking over. Staff were sending weekly updates to the office team in relation to any changes in people’s needs. However, some of the care plans we looked at had not been updated with the recent information which the carers had sent in and was logged on the clients’ diaries to ensure that staff were provided with all and the most up to date information in relation to the person’s care and support needs, for example catering for a situation when a carer would need to leave the package without time for a handover.

People and their relatives did not express any concerns in relation to the care they received. They confirmed they were involved in planning and reviewing their care.

Staff were knowledgeable of people’s risks related to their care and support and their needs; however, care documentation was not supporting them with robust information that was evidence- based and in line with good practice standards.

We did not see evidence of how the service ensured that staff were up to date with national legislation, evidence- based good practice and required standards as they were not routinely provided with person specific training.

Please see our judgement in relation to this under the safe key question.

There were no recognised assessment tools and guidance in place to provide staff with the information they need in the correct use of appliances used to deliver care.

There were not effective processes in place to support the needs of people who were at risk of falls and the development of pressure ulcers.

Staff did not always receive specialist and person specific training to meet people’s needs.

Please see our judgement in relation to this under the safe key question.

Information was available to staff in relation to the support people required to eat and drink.

People and their families were confident that staff would contact a healthcare professional if required.

The management team provided examples of how they worked with staff and professionals. One staff member discussed with us about the work they did and support they provided to one person whose needs were changing, by engaging with the emergency services and the GP and persisting in emphasising to healthcare professionals the importance of attending to the person.

Feeback we received from professionals working with the service evidenced a good working relationship. One professional told us; “I can confirm that I have worked with 1-2-1 Live in Care company to support several service users. My experience with the company has been very positive. In particular, I have worked closely with the manager who has consistently been very responsive, proactive and approachable. [Registered manager] has always prioritised the safety and the wellbeing of our service users. The clients and the families that I have spoken with have also been satisfied with the services provided by 1-2-1 Live in care and stated that they felt safe and well cared for.”

The service had systems in place to work with health and social care professionals such as district nurses, occupational therapists, and GPs.

People and their relatives did not share any concerns in relation to the support they received to live healthier lives. One family member told us, “They ask him what does he want to drink and he says `yes` to coffee, hot chocolate or water, he drinks lots of water.”

Staff provided us with examples of how they supported people for example with eating and drinking and how they, in some cases, monitored their intake to monitor adequate nutrition and hydration. Staff were aware of people’s oral health support needs and described how they supported people remain independent in this area.

The service worked in partnership with people and their families to help them to maintain a healthy lifestyle and access appropriate health care services as needed, such as district nurses, GPs, physiotherapists and occupational therapists.

Care documentation informed staff whether people needed support with oral health needs.

People were positive about their care and their needs and expectations were met.

Staff provided us with examples of how they monitored people’s care to ensure better outcomes and how they engaged with healthcare professionals when needed.

Staff worked in collaboration with people and their families to ensure good and consistent outcomes for people.

People’s care documentation contained information about their desired outcomes.

There were systems in place for the management team to engage with staff and people to ensure they were kept up to date with any changes in people’s needs, however improvements were needed to care documentation to ensure it was reflective of people’s risks and needs and updated without delay when updates were received from staff.

People and their relatives did not share any concerns in relation to staff asking for consent and involving people in making day to day choices.

One relative told us; “Everything is done with his humour in mind because if he is in good humour he is happy. They are always polite and include him in every decision. They are approachable and friendly, quiet and responsive.”

Staff were aware of principles of the MCA and knew where to find information related to people's decision-making abilities and preferences. They provided examples on how they sought consent from people and how they provided and explained information to people to ensure they made their own choices.

One staff member told us that mental capacity and consent means that the person has the capacity to make a choice, “knows [their] own mind, has the right to choose.” They would respect choice and unwise decisions while ensuring the person’s safety.

The registered manager told us that at the time of the assessment they did not support anyone who lacked mental capacity to make decisions and talked to us about the process they would follow to complete mental capacity assessments and best interests decisions. However, the process of gaining consent had not been consistently implemented in the service.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA).

When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty

We found that the service was working with in principles of the Mental Capacity Act. Information was provided to staff in care documentation in relation to people’s decision-making abilities.

While some systems were in place to gain consent from people, for example in relation to the support they received with medicines administration, the service did not apply the same system to seek consent from people in relation to the delivery of their care and support.