Candlelight Homecare Service Limited (East Sussex)

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.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. However, improvements were needed to record keeping.

Assessments were completed before people started using the service. This helped to ensure people received the support they both needed and chose. One person said, “The pre-assessment was good and helpful.” Care plans and risk assessments were developed to reflect the required support. This support was regularly reviewed to ensure it continued to meet the person’s needs. We identified that although people’s needs were reviewed and reassessed the care plans did not include all the relevant information staff may need. However, staff knew people well and provided the care and support people needed.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, improvements were needed to ensure care and support was always based on good practice and standards. They did this in line with legislation and current evidence-based good practice and standards.

Care was delivered in a way which met people’s needs and preferences because staff knew people well. For example, where people had specialist needs, staff received relevant training to ensure they had the knowledge needed to deliver care in an effective way. One staff member supported an autistic person and people with a learning disability. They had completed further training to ensure these people’s needs could be met. However, improvements were needed to ensure records reflected that care and support was always based on good practice and standards.

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.

Due to the purchase and merger of the second company there had been conflict within the staff team. Most staff told us that this was now improving. One staff member said, “These last 2 weeks (before the inspection) things have started to feel better. Back to where we were.”

People generally received support from a regular staff team. However, this had been impacted by the merger with the second company but was being resolved. People and staff knew each other well. This gave staff a greater understanding of how people liked their care and support provided. One staff member told us they had people who they regularly supported but if they were given someone they did not know they would discuss with the office staff to get some background information before they visited. Staff shared information internally to ensure changes to people’s needs were known across the staff team.Where required staff worked with external professionals to help ensure people received consistent support.

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 supported people to manage their own health needs where possible. They supported people to attend appointments and complete tasks to stay well. One person was considered to be overweight. Therefore, staff supported them to take walks and also reminded them to weigh themselves and record their weight.

Staff supported some people with their nutrition. They helped people to maintain a diet of their choice. Although improvements were needed to some aspects of nutritional care plans there was information about what people liked to eat and drink, including tea and coffee preferences. There were reminders within the care plans to ensure people had drinks accessible, for example, before staff left the visit, to help maintain hydration. One relative said, “They try to make sure [name] stays hydrated by drinking enough water.” One person told us, “I have ready meals, but they will look and see what is available offering a choice.”

Staff told us that if a person was unwell, they would contact the relevant health professional or report their concerns to the office staff who made the referral on their behalf.

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

Staff gave examples of how outcomes for people were monitored and reviewed to drive improvements. They used a range of methods to monitor people’s care, including monitoring calls, care reviews, and spot checks. Although improvements were needed to aspects of care planning, care review records showed how care was adapted to meet people’s changing needs and preferences. Each care plan included a goal and outcome.

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

Staff had undertaken Mental Capacity training and applied this to their practice. Staff told us how they ensured people’s consent before providing care and assessed their capacity when supporting to make decisions. One staff member told us that a person who was living with dementia may decline care or medicines. The staff member said, “I just do something different and then go back and ask again. If they still refuse, then I will respect that decision and let the office staff know.”

Mental Capacity Assessments and Best Interest Decisions had not always been recorded. Staff told us that whilst they understood Mental Capacity they were finding it difficult to document clearly. This had already been recognised as an area to be improved, and further training had been arranged.

Where people required the support of a legal representative to make decisions, this had been reflected within care records and copies of appropriate information held on file.