Hippo Care Limited

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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.

This is the first assessment for this service since it was registered. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.
 

This service scored 63 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

We received mixed feedback from people about an assessment of their needs. Some people told us they had received a visit from a senior member of staff who asked them questions about their views and preferences. However, other people told us the care was arranged by the local authority and they only met the care staff on the first support visit they received.

However, most people told us they felt involved in decisions about their care. Care plans did contain some preferences and where possible these were taken into account. For example, people were often asked whether they preferred male or female care staff, and these preferences were usually respected. One person told us “I only have female staff I would not want a male carer.”
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider did not routinely ensure they followed best practice guidance for administering and recording of prescribed medicines and care plans did not always provide best practice guidance on skin integrity. For instance, although care plans referred to the importance of repositioning for people at risk of a deterioration in skin health, the documents failed to ensure mitigating factors were clearly documented. For instance, what type of equipment was needed to reduce pressure damage.

However, staff told us they received training in key areas such as diabetes and modified diets as examples. One member of staff told us how they supported a person who was at risk of choking. They said, “I follow the SALT (speech and language therapist) instructions precisely and ensure they eat slowly.”

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.

Systems were in place to share information with staff. Staff told us, “Communication between carers, nurses, hospitals and the office is strong.”
 

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 and their relatives gave us positive feedback about how the care staff supported them with their health. One person told us, “My support worker has got me into a proper routine.” Another person told us care staff “have been my lifeline.”

Staff told us they look out for any changes in people’s needs and report this to the office. One member of staff told us, “Recently, I noticed a pressure area appearing on a client’s lower back. I contacted the office, who arranged for a district nurse assessment. The GP was also informed, and appropriate equipment was provided. This coordination ensured early intervention.”
 

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

We found care plans guided staff on how to manage people’s conditions, however, this was not routinely evidenced in care staff records. For instance, one person’s care plan stated they required to have daily support with monitoring blood sugar levels, food intake and care staff should, “Document the result and any observations in the daily care notes.” However, we found this was not routinely recorded.
 

The provider did not always work within the guidance of The Mental Capacity Act 2005 (MCA). 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 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 there was a lack of understanding about when a third party could act on behalf of another person. Care plans routinely stated family members were decision makers, however, the care plan also stated the same family member stated in the each care plan did not have any legal powers to act on behalf of the person.

Care plans were not always clear if a mental capacity assessment had been completed. The provider did not supply completed mental capacity assessments when we initially requested all care planning documentation. When the provider shared completed mental capacity assessments (MCA) it was clear they did not always understand when to complete them and to ensure MCA’s were only completed when required.