Best West Bridgford Home Care Ltd Also known as Home Instead Central Nottingham and West Bridgford

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

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. 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 58 (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 ensure people’s care and treatment was effective, as they did not consistently review and discuss people’s health, care, wellbeing, and communication needs with them. Initial care consultant visits were completed prior to people receiving care to assess their individual needs. However, effective systems and processes were not always in place to ensure care plans were reviewed and updated when changes occurred in people’s health or wellbeing to ensure care plans were always in place for all aspects of people’s care needs.

Relatives told us they had been involved in care planning and reviews. One relative told us, “[family member] does have a care plan which is reviewed I think about every six months. I get an e-mail from the office asking me to contact them with dates that would suit me at our convenience. I feel that the review meetings are helpful and very inclusive.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them, whilst people were involved in their care planning. Staff had not always ensured evidence‑based care and treatment was followed. For example, one person had an injury where skin damage had occurred. However, there was no care plan or risk assessment in place to guide staff on how to provide appropriate support. Daily notes showed staff practice was not in line with infection, prevention and control guidance. This meant staff did not have clear guidance to support the person safely and reduce the risk of further harm.

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. The registered manager told us, “If people move from their home into a care home, we offer companionship visits to help maintain continuity. We also work closely with the care home to ensure they have all the information they need regarding the person.” This meant people experienced safer transitions of care, with information shared appropriately to reduce risks and maintain consistency in their support. A relative told us, “[staff] do come out and review [family member’s] care, and they come to see if the care needs to continue as it is or changed when mum is discharged from hospital, and the care needed to be increased and they were able to put that in place quickly.”

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 demonstrated a good understanding of people’s, lifestyle, and cultural needs. This enabled staff to monitor people’s wellbeing and identify changes in their needs in a timely way. Staff supported people to maintain independence and encouraged access to the local community. For example, one member of staff supported a person to research local activities and clubs in line with their preferences and interests and planned to accompany them to these activities to support social inclusion and their wellbeing.

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

Staff completed daily records of the care they provided, including changes in people’s health and support needs. The registered manager told us these were reviewed weekly; however, these reviews were not always effective as they did not consistently identify concerns. For example, we found one person had repeatedly reported feeling unwell, and appropriate action had not always been taken to support them to access a health professional or report this to their relative. This meant people did not always receive timely support to address changes in their health.

The provider told people about their rights around consent however the provider had not always followed the requirements of the Mental Capacity Act (MCA) 2005. Where people could be deemed to lack capacity, decision‑specific capacity assessments were not consistently completed. As a result, best‑interest decisions were not always fully considered, documented, or evidenced. This meant we could not be assured that decisions made on behalf of people who lacked, or may have lacked, capacity were always lawful or in line with MCA requirements.