Care Pilot Limited

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• 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 did not always make sure people’s care and treatment were effective because they did not always check and update care plans to provide staff with effective and current guidance on people’s health needs.We found one person’s care needs had significantly changed and they were receiving all care in bed, however the care plan did not reflect this. The registered manager updated us to advise this care plan had been updated. Another person’s care plan indicated they had no allergies, but their care plan stated they had coeliac disease which is a condition where the body has a negative response to gluten in food which should have been more clearly highlighted.The provider consistently completed a robust initial assessment before people received care and discussed people’s health, care, wellbeing and communication needs with them. However, not everyone we spoke with recalled having a review of their care needs. One relative said, “There was a meeting at [relative] house when they[provider] first started, and they asked lots of questions about his needs so that they could let the carers know (Care Plan).”

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. The registered manager told us about how they carried out assessments, considering what was important and mattered to people. They gave an example of how they approached this, “For me it’s more like understanding what they like and being led by them, understand what makes a difference for them, and makes them happier, understanding what they want and making sure we allow them to express their desire and what they would like to do.” Staff spoke with us about delivering evidence-based care including support with food and drinks. One staff member told us, “I have some clients which have strict dietary needs, and an example is lactose intolerance. I make sure to give them meals which align with their restrictions for example, no dairy products.”

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. We saw evidence of communication between the management team and external professionals regarding health and wellbeing concerns including contact with social workers about people’s support hours. The registered manager discussed an upcoming change of care agency for a person and explained how they would support with sharing information. They said, “If the receiving agency are receptive, we would provide shadowing opportunities and handover and include allocated social worker in discussions if possible. If required we will share our care plan, we understand it can be frustrating for clients to repeat information and if the client consented, we would share it.”

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 were supported with choice and maintaining their independence. One relative told us about their loved one’s care, they said, “My [relative] has been having care from Care Pilot for 2-3 years now, I think. They began at 4 visits a day, but the current call level is once a day as [relative] has improved and learned how to be more independent again, which in some ways is down to the carer support.” People’s care needs including what they could do for themselves was documented in their care plan. Staff understood the importance of supporting people to maintain their independence and offering people choice, so they were empowered. One staff member told us, “We encourage people to be independent. We make sure they give consent, support people to make choices, for example, we ask them what they prefer to wear, ask them before making food what kind of food do they want to eat so they choose this.”

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 and people’s expectations. Care records evidenced people were supported to attend medical appointments and people’s care was overseen by the registered manager to ensure people’s health and care outcomes were positive. We saw accidents and incidents were reviewed, information analysed and improvements to care made as a result. The electronic system that the provider used meant the management team had good oversight of the care people received. Staff directly monitored people’s welfare. One staff member told us, “Whenever there is a change in the needs of a client, such as deterioration in their physical health, I inform the team leader or line manager. I also make sure to inform their families and GP to get proper information about their change of needs.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We reviewed care plans which evidenced people had consented to their care. Where people were unable to do this independently, appropriate people were involved in decision making, for example family with legal authorisation to do this. We saw examples of where people’s capacity had been assessed and where people lacked capacity to make a decision a decision was made in the person’s best interest with the support of appropriate professionals and loved ones. Staff were trained on and had a clear understanding of the Mental Capacity Act (MCA) and how this impacted people’s care regarding consent and people’s rights. The registered manager told us, “Basically, the starting point is everyone is assumed to have capacity unless proven otherwise and we would use MCA to assess a person’s ability to make a decision but also acknowledge that being unable to make a decision about a certain aspect of their life doesn’t mean they don’t have capacity overall. We are targeting specific areas/decisions, if a person makes a poor decision doesn’t mean they don’t have capacity.”