Bliss Care And Training Ltd - Barnet

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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 was effective because they did not always effectively check and discuss people’s health, care, wellbeing and communication needs with them.

The provider had ensured people’s needs were assessed. However, this was not always completed in an effective way. Some people faced high risks each day. These needs were assessed but they did not explore the risk fully. Some aspects of these high risks were not identified such as when a person used oxygen therapy and when people smoked. Staff did not have clear care plans to follow and to evidence the provider had told staff what they needed to do to fully manage key risks. The assessment of needs had improved from the last assessment, and no one had come to harms as a result of this. But further work was still required to promote people’s safety.

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

The provider ensured those staff supporting people with more specialist care such as catheter care and with complex ways of eating and drinking had appropriate training from a registered professional.

The provider had created very long and at times repetitive assessments and care plans. Staff were given a list of the tasks they needed to complete when they provided personal care to people. However, staff could not explain to us what key risks individuals they supported faced each day. We concluded these risk assessments and care plans were too long and staff were not looking at them. This limited their understanding of people’s assessed needs. We fed this back to the provider advising them further work was needed here. They told us they would correct this.

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 were confident if they were ill staff would respond directly to them advising to see a GP or share the same information with their relatives. Staff spoke to us about what they did to ensure people received medical assistance from paramedics when they felt this was necessary.

When staff needed to play a role in helping those who had skin wounds and pressure sores to improve, people’s relatives told us this was happening. As one person’s relative said, “[Name of person’s] pressure sore is improving. The staff are patient and encouraging.”

Staff were directed to promote healthy lifestyles when they supported people to eat and drink. As one person said, “The [member of staff] gets food from the store for five days. He gets me the right food. I’m getting enough food and drink.”

The provider did not always effectively monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive.

The provider completed reviews of people’s needs routinely and without fail as a way of monitoring people’s needs and the risks which they faced. Staff practice was checked in certain areas of their work, routinely. In these situations people would be asked for their views and provided feedback of the care they experienced. Further work was needed to review some key high risks at these reviews and check the person’s own responsibilities who had the capacity to do so, to manage the risks they faced each day.

People had limited daily notes which did not document all the tasks they completed. These records did not show staff had considered the key high risks for some people and they were satisfied the person was safe. For example, were there any signs some high risks were not being managed and if so had they reported it to the office.

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

The provider had made improvements with staff’s understanding about consent and mental capacity to make certain decisions about their daily needs. People had capacity assessments which fully explored their understanding of certain decisions they were making about their lives. These records were well evidenced to show how the assessor had reached a particular conclusion. Staff were also mindful of people’s choice to make unwise decisions and live their life as they wanted to.