Tender Hands Homecare 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 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 71 (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 before support commenced, and there was evidence assessments and care plans and people’s risk assessments were reviewed regularly to reflect changes in people’s circumstances and needs. One person told us, “I went through all the care plan needs with them [the provider] when we began.” One relative told us,” I was involved with setting up my loved one care plan when they began having them and it is reviewed regularly and changes have evolved with my loved one needs.”

Care and support provided to people was recorded electronically. However, care records were not always sufficiently detailed to provide a clear account of support delivered. The provider had identified this an as area requiring improvement through their own quality assurance processes and had begun taking action to strengthen the quality and consistency of care recording.

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.

Staff demonstrated a good overall understanding of best practice and used their knowledge to ensure that people's needs were met effectively. Care plans were generally detailed and person-centred, and we saw evidence they were reviewed when people's needs changed. People and their relatives were actively involved in care planning and discussions about their individual care needs.

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.

Staff worked well together and in partnership with external healthcare professionals, including district nurses, pharmacies and GP practices, to support people effectively. The provider demonstrated a strong understanding of the importance of collaborative working and recognised the positive impact this had on people's health, wellbeing and overall care outcomes.

Staff spoke positively about the support they received from colleagues and management. One staff member told us, “The staff and management work well together, and there is a good support network for staff.”

The provider was committed to ensuring staff felt supported in their roles and were encouraged to raise concerns, share feedback and make suggestions for improvement. Staff told us they felt able to approach managers when they needed guidance or support. We also saw evidence thatthe registered provider was contacting staff by telephone following their first shift to ensure all went well and staff didn’t need any support.

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 very good understanding of people's individual needs, preferences and routines, and were knowledgeable about how their care should be delivered. Relatives spoke positively about the personalised approach taken by staff and the provider's responsiveness to changing needs.

One relative told us, “If we have any thoughts at all about any changes, even just to add making my loved one a cup of tea, then we call the registered manager, and they will add this to my loved one's care plan.” This showed that people and their relatives were actively involved in planning and reviewing care.

Another relative said, “Staff are just marvellous with my loved one. They are very particular about things and staff always respect this. Staff encourage them with their illness and make them feel good.”

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.

People were supported by a consistent staff team who knew them well and understood their individual needs, preferences and routines. This helped to ensure care was delivered in a person-centred way and promoted positive outcomes for people.

Systems were in place to monitor people's outcomes and review the quality and effectiveness of the care provided. Records showed that people's needs were regularly assessed, and care was reviewed to ensure it remained appropriate and responsive to any changes in their circumstances. One person told us, “The manager comes out regularly to check up on how it is all going, probably once a week.”

The provider sought feedback from people and, where appropriate, their relatives, to understand their experiences of the service. Feedback received was consistently positive about the care and support provided. One relative told us, “I’m very happy with my loved one’s care and so are they”. However, there was not always clear evidence to demonstrate how this feedback had been analysed and used to drive service improvements. The provider acknowledged this and had included actions within their improvement plan to ensure feedback is more effectively captured, reviewed and used to inform the ongoing development of the service.

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

Policies and procedures were in place to support compliance with the Mental Capacity Act 2005 (MCA). Staff demonstrated an understanding of the importance of seeking people's consent and ensuring care was delivered in line with their wishes, preferences and individual needs.

However, the provider did not always demonstrate a clear understanding of their responsibilities under the MCA. For example, there was limited evidence of capacity assessments being completed where required, or of best interest decision-making processes being followed when people lacked the capacity to make specific decisions about their care.

We discussed these concerns with the registered manager, who responded promptly to our feedback. The registered manager took immediate action to review their duties and responsibilities in relation to the MCA and identified areas for improvement within the service.

Actions to strengthen oversight, recording and application of MCA principles were incorporated into the provider's action plan to help ensure care decisions are made in accordance with legal requirements and best practice.