Witham Community Care 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 newly registered 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 79 (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. Most people were referred to the service by word of mouth or private recommendations from pre-existing clients. A thorough pre-assessment process was completed by 2 members of the management team. This involved a home visit where all care and support needs were discussed with people and their loved ones. Where appropriate other professionals opinions were requested. For example, Physiotherapists, GP’s and other specialists involved in the person’s care journey. Preferred ways of communication were established and recorded to make sure people fully understood the process and the nature of the support being proposed. Contracts would only be drawn up if the manager assessing knew that they had the staff with the right skills and training to support the person’s needs. A person said, “For pre-assessment my daughter was there and they went through everything with us. They discussed what I wanted, what I expected as well as what I actually needed.” The registered manager told us they acknowledged that it was often difficult for families, navigating the care system for the first time. They told us they spent as much time as was required with people to reassure them. Staff would slowly be introduced to people to make sure they were compatible and that they were able to get on well together. Staff would only work independently with people after these connections had been established. Regular reviews took place of people’s changing care needs and staff told us they could raise any issue with managers if they felt a care package needed adjusting.

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. People and their loved ones were involved in the planning of their care and support and stated what their preferences and preferred routines were. These were recorded and respected by a staff team who knew them well and were able to adapt to meet people’s needs if circumstances changed at short notice. Requests for support from other professionals were made in a timely way to make sure people received the best support possible. For example, contact with people’s GP’s.

The registered managers 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. Effective working relationships had been established with other professionals involved in supporting people. This led to a joined up approach to meeting people’s needs. Communication between the service and other adult social care professionals was consistently successful and people received the support they needed in a timely way. A relative commented that their loved one’s GP would contact the registered managers for information and advice, demonstrating the effectiveness of professionals working together. A professional told us, “Should I need to speak with the registered managers they are accessible and proactive, this high standard of communication continues between their management team and staff.” Another professional added, “We have a number of other clients who have been supported extremely well by Witham and I wouldn’t hesitate to recommend them to anyone, and indeed to my own family if care and support were needed.”

The registered managers 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. Most people were independent with their nutrition and hydration needs or were supported by family members. Independence was encouraged by staff as well as achieving a balanced, healthy diet. Staff in some cases prompted or reminded people to eat and drink and in a few cases a higher level of support was needed. A person said, “They check to make sure I’m eating and drinking enough.” Staff had received training in nutrition and food hygiene and care plans reflected any particular needs or preferences, for example, which implements people preferred to use and preferred timings of their meals.

The registered managers monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. The registered managers and wider staffing team were exceptional at improving outcomes for people. In some cases, the support provided was sufficient over time to enable people to live completely independently again without the support of the service. In achieving this, staff provided continual support to encourage and support people to regain their confidence or to simply more effectively manage their lifestyle. In one case a person was not managing their medication well and did not have adequate support of close family or loved ones. Consequently, they had become less able to manage in all aspects of their personal care. Staff quickly identified the root cause of the issue and, working closely with the person’s GP, put in an effective process to support the person take their medicines appropriately. Over time and when the routine was established, the person became more settled and able to manage their personal care. Support was then withdrawn as it were no longer needed but the registered managers maintained contact to check on their continued progress. The initial contracts drawn up with people were for ongoing care that was expected to continue and not short term rehabilitation support. In other cases, people had returned home following a stay in hospital and the immediate support provided by the community rehabilitation team needed to be extended beyond their time parameters. The service had stepped in to support people and in some cases managed to completely get people back to independent living and again, ongoing care calls were no longer required and support was no longer required. The registered manager had arranged for enhanced training for staff, provided by medical professionals, to give them the skills to take people blood pressure and check vital signs and monitor people’s weight when needed. These findings were then recorded and over a short period of time identified if any additional support was needed. A person said, “They take my blood pressure very month, which is wonderful, they look after me. I had a swollen ankle recently and they helped me contact my GP.” Recognised tools for measuring people’s likelihood of acquiring pressure sores and for monitoring people’s nutritional intake were available to staff and were used in some cases. Staff being fully trained in understanding these measures, how to record them and then know what actions to take if needed. All of these interventions enabled people to live the best lives that they could and in some cases to return fully to independent living without the need for support.

The registered managers told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff acknowledged the importance of gaining consent from people before carrying out any task or activity. Staff knew people well and those who experienced difficulty in verbalising their consent would sometime nod or use other facial expressions to signify if they were happy or not. A staff member said, “With dementia we get the complete spectrum with some confused days. Try and get them to make decisions no matter how small for example, food choice. I will always seek consent.” Another staff member told us, “Capacity does vary but I know them well and know how they consent. One man speaks little but nods and I know that is ok but will always check again.”