Right at Home Lymm and Warrington South

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 Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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. People's needs were assessed by the provider before they started using the service. These assessments outlined each person’s individual needs and they support they required. The assessments also identified risks to people’s safety and wellbeing. Once completed, the assessment was used to develop each person's care plan. Care plans were developed in consultation with people and their families. They were person-centred and regularly reviewed.

The provider had processes in place supporting the planning and delivery of people’s care and treatment with a variety of needs, in consultation with them. They did this in line with legislation and current evidence-based good practice and standards. The provider worked closely with other health professionals such as doctors, district nurses, and local pharmacies. Staff received training to help them meet people’s needs including basic life support, stoma care, catheter care, and good oral health. The provider understood the CQC regulations and standards relevant to the service.

The service demonstrated how technology was used to support evidence-based, person-centred care. A person recovering from an acute health condition required regular physiological monitoring. Trained staff used the technology to record observations, to support recognition of changes in the person’s health.

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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 provider had systems in place to make sure information was shared in a timely manner by everyone involved in people’s care. This ensured a joined up, consistent approach to delivering safe and effective care to people in line with their individually assessed needs and preferences.

Support plans included details of other professionals who were involved in their support. Changes to people’s care needs were communicated to staff via the electronic care planning system. Staff confirmed they had regular individual supervision, and systems were in place to support communication between staff.The provider worked in partnership with primary health services through the use of technology to provide better health outcomes for people they supported.

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’s health needs were recorded in their care plans and regularly monitored. Staff responded appropriately when people's health needs changed. Details of people’s doctors and other health professionals involved in their care were included for staff to reference. In some cases, hospital passports had been devised if a person needed to be admitted to hospital. This gave hospital staff relevant and up-to-date information about the person’s health needs, prescribed medication and anything that could affect a person’s ability to communicate.

Families told us people’s health had either improved or remained stable while receiving support from the service. People were supported to remain living in their own homes, in line with their wishes and long-term goals. One family member told us, “Yes, [Name] health has improved since starting using the service in particular with personal hygiene and skin health.”

The provider used technology to provide ongoing information to enable them to lead healthier lives.

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. Quality assurance processes included regular audits of the quality of care provided. This was done at managerial level as well as from the quality team within the wider organisation on a regular basis to ensure compliance. An action plan of required actions was devised and reviewed regularly. Records showed people’s health and social care needs were monitored in line with their assessed needs. This information informed reviews and ongoing care planning, helping to ensure people received appropriate support.

The provider gave an example of how staff monitored changes in a person’s health and used these to review their care. Following an incident involving reduced mobility, staff considered the person’s increased frailty and involvement of the other health professionals and discussed whether additional care visits were required.
The provider described using incidents such as this to support supervision, team learning and quality review, including checking whether staff recognised and escalated changes, used assessment tools appropriately and reviewed care when people’s health or mobility changed.

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

People told us staff always asked them for their consent before supporting them with their personal care. Staff had received training in the Mental Capacity Act (MCA) and were knowledgeable about people who could not always give consent. Assessments to determine their ability to make decisions had been made. The provider had sought ongoing consent from people who could not always give written consent to their care plan due to a disability which affected their communication. Consent forms had been signed by people consenting to their care plans verbally. Consent had also been given to those who wished the provider to contact their doctor in the event of them not being able to give consent due to a health crisis. Where people required their medications to be covertly given; this had been identified by the provider and a best interest process had been held to agree the covert administration of medicines was in the best interests of people. This best interest process had involved several people involved in their support.