Care First 24 Ltd

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 Outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 96 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

People, their relatives and healthcare professionals told us that the impact of the support from Care First 24 had been life changing. The provider worked with all stakeholders to assess people’s needs from the initial assessment, throughout the package. This included regularly reviewing people’s care to make sure it met guidance and legislation and working to the least restrictive practice where possible. A healthcare professional told us that the provider had been able to implement a less restrictive package of care for the person they supported. This resulted in a reduction of distress for the person, through increased and meaningful activities introduced by staff. A relative told us, “When I look at my son now compared to how he was, he was a traumatised young man, he’s back to how he was.” When restrictions are reduced, people experience better mental health, fewer injuries, and a higher quality of life.

People’s needs had been fully, holistically assessed prior to support being provided with tailored care packages then being created with the person at the centre. Staff knew people well, because they had detailed care plans and risk assessments to learn about people. When people’s needs changed, this was documented and communicated with staff and people’s care plans evolved with them. People were supported to receive annual health checks and any associated follow ups including blood tests. A relative told us, “If I was to mark them I would give them 100%.”

People’s communication needs were clearly set out within their care plans. Some people were not able to communicate verbally and where this was the case, guidance clearly set out how to communicate with the person. For example, some people used communication aids including picture exchange communication system (PECS), or Makaton. PECS allows people to communicate using pictures. Makaton is a language programme that combines signs (hand gestures), symbols (pictures), and speech to help people communicate. Staff described how people used their communication cards to actively shape their day choosing what they wanted to do and what they wanted to eat. By using the cards, the person gained a powerful way to express themselves, which staff said had a meaningful impact on their independence and voice.

The provider always 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. They worked to develop evidence-based good practice and standards.

People received care which was evidence based, and in line with good practice standards. Within care plans there was good practice guidance and reference sheets to remind staff on best practice when supporting people. This included visual guides on how to observe if people were dehydrated, and actions to take to support them to be well. There was also guidance in people’s care plan’s to remind staff about safe medicines administration practices, and actions to take if a person choked. People were told about current good practice that was relevant to their care and were involved in how this was reflected in their care plan.

For example, one person started using the service who was prescribed an antihistamine to be taken in the evening. When staff noticed that an evening antihistamine was making them drowsy, they worked with the GP to move the dose to the morning, improving its effectiveness. Using social stories to support the change, staff helped the person maintain their routine and as a result, they became far more engaged and interested in evening activities. Staff told us, “We have given them back control of their time. Now they get to do what they want to do and life as they want to live.”

People and their loved ones were at the heart of planning their care. People and their relatives told us that their needs and wants were prioritised by staff. Staff understood how to read people’s individual communication needs to understand how they wanted their care delivered. For example, one staff member told us that the person they supported would make it very clear if they didn’t want care delivered, through facial expressions and gestures and these were known and understood by staff. Before packages of care started staff took time to get to know people and understand how they wanted their care planned, and this was regularly reviewed by staff to ensure it met people’s needs.

Staff completed regular audits on the service, to ensure they were meeting current guidance and legislation. For example, an audit was completed monthly to ensure that the team of staff supporting people with a learning disability, were meeting the RSRCRC guidance.

Healthcare professionals told us they had confidence staff and the provider could support people in an effective way. A healthcare professional told us, “If I have a reason to call Care First 24 regarding a package, they are quick to respond and knowledgeable about what is happening in the package.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

People and their loved ones told us that staff had been exceptional in working with other stakeholders to deliver people meaningful outcomes. One person needed a hospital intervention that could have been deeply distressing for them. Staff told us how they used social stories, Makaton and artificial intelligence to gently prepare the person, helping them understand what to expect in a way that felt safe. They also worked closely with the hospital to make sure the person was seen first, reducing waiting time and easing their anxiety. Staff described how these small but thoughtful actions made a big difference, helping the person face a frightening experience with far more confidence and calm. Staff told us there was no distress shown by the person, and that they did “really well.”

On the occasions when things weren’t working, a relative told us that senior staff were there the next day to ‘figure it out.’ They told us of the staff that supported them, “She’s really hands on to get stuff done and the same with the care. They’re all amazing.” They also told us, “They all take ownership for the work, it’s not an individual, it’s a team and they’re all working towards the same goal. There’s no ego, everyone is just part of a goal.”

The provider always supported people to manage their health and wellbeing to fully 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 were passionate about supporting people to live as healthy lives as possible. The provider instilled a culture of supporting people’s mental and physical health and did so through supporting people to gain weight when needed and reduce the use of physical interventions which the provider recognised was distressing for people and staff.

People had been supported to gain weight when needed. For example, one person had lost significant weight prior to being supported by the service. Their loved one told us, “Their diet is very good. Before they were putting food in the bin and not allowed in the kitchen. When I look at him now, he’s gained his weight, he’s now back to how he was.” Staff supported another person to find a way to monitor their weight whilst using their wheelchair, which supported the person control over their own health and wellbeing. A relative told us, “It’s one of the best agencies. They are excellent.”

The provider told us of the importance of supporting people holistically including their wellbeing. For example, one person had to travel to London regularly for treatment. Staff ensured that each trip included doing something special for the person, so that the trip was remembered for activities which improved the persons wellbeing as well as their health.

The provider 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.

People and their loved ones told us about the positive impact being supported by Care First 24 had on them. One person had been supported to move from a placement where they were not receiving the support they needed. Staff transitioned them home and supported the person through this journey, which had a positive impact on the person and their loved ones. A relative had fed back that having the provider support their loved one had, “Saved their life.”

The provider placed equal importance on supporting people’s clinical needs with their physical, mental and social needs. One person had been supported to reduce their support needs through consistent skilled, understanding staff. Through this support the person’s care had reduced from having 3 staff supporting them, to having 2, whilst increasing their life experiences. The person had been supported to go to a local fair for the first time in their life, experiencing the rides and enjoying candy floss. The provider told us, “It’s everything to see that.

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

People’s capacity had been assessed and documented within care plans to inform staff. Care plans contained reminders for staff to seek consent when carrying out care. People and their relatives told us that their loved ones were given choices and their right to decline was understood and respected by staff. Relatives told us, “He doesn’t decline care, I think he’s declined his teeth being brushed once since they took it over, they give him some time, they offer it again and if he declines, he declines.”

A healthcare professional told us, “The provider showed that they were caring, and their knowledge of mental capacity legislation and multidisciplinary working was exemplary.” Relatives told us that when people could not always explicitly consent, staff understood and acted in their best interest. A relative told us, “They give my son they right to make his choices. They know by his facial expressions to see what he wants.”