Sevacare - Kingstanding

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. Care plans were personalised and people and their loved ones were involved in their development. This included regular reviews. People were happy with the support they received to eat and drink well. We received mixed views from people and their loved ones about how punctual carers were, how long they stayed for and communication about late care calls. Some people were very happy with this aspect of the service and others were less happy. Staff understood people’s capacity and ability to consent to care. The design of consent forms meant it was not clear why loved ones were being asked to sign them.

This service scored 62 (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. Care plans and risk assessments contained personalised details about how people wanted to be supported. People and their loved ones told us they had contributed to the development of their care plans and had regular reviews. We received mixed feedback from staff about how often they would look at care plans. One staff member told us, “I always look at the care plan before I see someone new... the care plan gives us good details.” Other staff said they looked at the care plans less frequently, however some staff were supporting the same people for many years. We found that carers knew people’s needs and wishes well. People had plans which detailed any information staff needed to ensure clear and effective communication. People and the relatives we spoke with told us they all had access to their care plans as a copy was kept at home. One person told us, “[The carers] are fully conversant with the care plan which I am involved in at all times.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. People’s nutrition and hydration needs were met in line with current guidance. Staff worked alongside the Speech and Language Therapy Team to ensure risks were mitigated. We saw one person’s care plan contained some guidance about staff offering a particular food without the guidance needed to make the option safe. We discussed this with the registered manager and the guidance was updated immediately. There was no evidence the person had come to any harm from this error. Staff we spoke with about the person’s care knew how to support them safely and with their nutrition and health needs. Tools were used to monitor people’s wellbeing. These included assessments to determine possible risk of falls and risks to skin integrity. Most people and relatives told us they were happy with the effectiveness of the care provided by staff. One person told us, “I have learned so much from [the carers] they show me the easiest way to do things.” A relative told us, “On the whole they are wonderful, they let me know anything we need to keep an eye on.”

The provider worked well across teams and services to support people. When a new care package was agreed with the EICT a team member would go out within 48 hours to the person’s home. They would help the person, and their loved ones review the care needs and risks for the person. Given the short time frame in which care needed to start, there were examples of people and relatives not knowing about the broader time windows for care calls in the EICT package and other initial communication issues. People gave mixed views about communication. Overall, they told us carers seemed to communicate well between each other about changes in people’s care needs. We received mixed views about communication regarding care call punctuality and duration. One person told us, “I don’t think communication between staff and the office is good.” Another said, “The communication with head office is very very good.”

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. Staff told us about ways in which they promoted people’s independence. They were able to describe signs they would look out for which may indicate a deterioration in a person’s health. Care plans detailed what staff should look out for to monitor for any deterioration. Care reviews included consideration of what people could do and wanted to do for themselves, and what they would need assistance with. People and their loved ones gave examples of ways in which they were supported to monitor their health and wellbeing. They consistently told us care was reviewed regularly to ensure health and wellbeing is maintained. One person told us, “We put the care plan together jointly so I have input into it and can understand it totally.”

The provider routinely monitored people’s care to continuously improve it. This helped ensure outcomes were positive and consistent. However we received mixed views from people and loved ones about punctuality and how long carers stayed for care calls. Some people told us carers were punctual and stayed for the agreed time. One person said, “she doesn’t dash in and out, sometimes she stays longer.” Another told us, “The carers don’t always stay. It should be for half an hour but its’ not always. It can be 10-15 minutes. I call one of them speedy.” Some told us carers could sometimes be late. Some people said they would get a call to notify them if the carer was running late, others said they would not be notified. One person said, “They phone me and tell me why and discuss whether I should wait for them or the office organises another carer.” One relative told us, “Once or twice per week [the carers] can be late by half an hour…They don’t contact us if they are late.” None of the people we spoke with were harmed by problems with punctuality or carers not staying for the full duration of the agreed care time. One relative told us their loved one was not able to go out if the carers were late with the morning call. The registered manager told us that people should always be notified if there is a significant delay to their care call. We reviewed the care calls for a month and shared with the registered manager the details of some people who were effected by variable punctuality and carers not staying for 50% of the agreed time. The registered manager ensured that all the carers who supported the people identified were spoken with. In a couple of cases, an informal change to timing which suited the person had been agreed with the carer and the office had not been updated. The registered manager assured us the care calls for people identified would be monitored weekly to ensure carers were attending when they should and staying for the length of time agreed.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Capacity assessments were completed for all people receiving care and consent to care was sought. We found in 2 cases we discussed with staff, that whilst consent was recorded as given by the person themselves, the carer felt the person did not have the capacity to make complex decisions. Capacity assessments in these cases had not considered that whilst some people can make basic day to day decisions, they may not be able to decide about complex matters, such as consenting to care. They did not consider a person’s ability to make decisions can vary, sometimes being able to decide and at other times not. We shared this information with the registered manager, who told us these people’s capacity assessments would be reviewed. They told us they would be reviewing consent and capacity assessments for anyone who may be unable to make complex decisions because for example they were living with dementia. This would ensure assessments were reflective of people’s capacity. They noted that consent forms could be confusing for people and staff. There was space on the consent forms for relatives to sign, but it was not clear why they were being asked to sign. The consent forms were re-designed to make this much clearer. Staff had a good understanding of people’s ability to consent to care and told us about they respected people’s right to refuse support. People and their loved ones told us staff were respectful and treated them with dignity. People were supported to have control of their lives and staff supported them in the least restrictive way possible and in their best interests.