Independence at home Limited

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.

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 54 (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 assessed needs were effectively reviewed.

Care plans and risk assessments did not always contain relevant information about people’s health and safety needs to enable them to receive care or treatment which provided good outcomes. For example, where records identified people had physical health and safety needs, people did not always have a care plan or assessment which provided guidance to staff on how these needs should be met. This meant people were at risk of their needs not being clearly known and understood by staff.

However, people and relatives were involved in the care planning process of people receiving support from the service. People and relatives told us their care was reviewed with them, and staff were able to tell us about people’s needs and how these should be met.

The provider did not always plan and deliver people’s care and treatment, in a way which was important to them.

Care records were not always in-line with evidence-based good practice guidance. While some information within people’s care plans made reference to being based on guidance from external healthcare professionals, where safety incidents occurred which might have justified assessment and guidance from external healthcare professionals, this support was not always sought. This meant people were at risk of their care and treatment not being delivered to them in ways which reflected their identified needs.

Staff understood people’s preferences, including how they asked for food and drinks, and relatives said staff supported their relative to access amenities within their communities.

The provider did not always work well across teams to support people.

Leaders did not always work collaboratively with external healthcare professionals and partners. While there were some occasions where the provider worked together with external services, this was not always the case and opportunities for greater multidisciplinary working were sometimes missed. This meant we could not be assured people received the right support at the right time.

However, staff and the provider worked collaboratively together. For example, staff meetings took place on a regular basis which provided opportunities for staff and leaders to communicate together, and staff told us the provider worked effectively with them, with 1 staff member telling us, “We work really closely together with the manager and office.”

The provider did not always support people to manage their health and wellbeing to enable them to live healthier lives.

People’s care records did not always contain relevant information needed to ensure people could be supported to positively manage their health and wellbeing. We found information relating to people’s health conditions and needs did not always contain the guidance staff needed so they could support people to live healthy lives. For example, people living with health conditions which affected how they received care did not have a care plan in place which directed staff how to support them. This meant people were at risk of their health needs not always being met.

Some staff had not received training relevant to some people’s health needs. However, staff demonstrated an awareness of the support they provided to people based on some aspects of their health needs. For example, staff told us how they supported people with their physical health needs which mitigated risks associated with these conditions. This was supported by the feedback we received from people and relatives.

The provider did not always effectively routinely monitor people’s care and treatment to continuously improve it.

People’s care plans and risk assessments were regularly reviewed by staff. However, this monitoring was not always effective as reviews and audits failed to identify the concerns we found regarding the lack of relevant information in people’s care records, and so was not always able to ensure people’s outcomes were positive and consistent. This meant there was a risk the care and treatment people received from staff might not always meet their needs.

People’s care was monitored by the provider undertaking visits of people’s homes, telephone calls to people and relatives, and sending satisfaction surveys to assess staff practice and to seek people’s and relatives’ feedback.

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

The service considered the Mental Capacity Act 2005 (MCA) when supporting people. Decision-specific mental capacity assessments were carried out for people in all areas of their care, and these were reviewed on a regular basis. People told us staff respected their wishes regarding how their care was provided, and relatives told us staff provided care based on people’s consent.

Staff training records showed staff received MCA training. Staff displayed a good awareness of the MCA and how they applied this to people they supported.

People told us their consent was sought and respected when they were provided care, with 1 person telling us, “They always ask me what I want and how I want to do things.”