Continuity Health Care Services PVT 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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (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 discuss people’s health, care, wellbeing and communication needs with them.

The provider did not always ensure assessments and care records accurately reflected people's current needs and the support required to keep them safe. Care documentation contained inconsistencies and omissions, including conflicting information relating to a person's sensory impairment within their fire evacuation risk assessments.

Assessments did not always contain sufficient detail to guide staff to support people. For example, there was limited personalised guidance within mental health risk assessments, insufficient information regarding choking risks and support strategies, and unclear records relating to the management and oversight of catheter care. We also found a lack of supporting evidence for recorded weight and BMI (body mass index) information, inconsistent recording of repositioning in line with moving and handling guidance, and limited evidence that people were being encouraged to maintain good oral health.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People's nutrition and hydration needs were generally assessed and care records usually contained information to guide staff in providing appropriate support. However, records did not always consistently reflect current needs or clearly demonstrate the support required. For example, documentation did not always make clear who was responsible for supporting a person with their eating and drinking needs, and updated guidance relating to their thickened fluids had not been fully incorporated into care records. This increased the risk that staff may not have access to the most up-to-date information required to support the person safely and consistently.

National clinical risk assessments were not always effective in identifying, monitoring and managing risks to people's health and wellbeing. For example, 1 person's pressure ulcer risk assessment identified them as being at very high risk of developing pressure damage. However, the assessment had not been reviewed following significant changes in the person's circumstances, including a recent hospital admission. The assessment also contained inaccurate and incomplete information.

The provider worked with external partners, including the local authority, to support improvements within the service. The management team engaged with the local authority in response to concerns following our last assessment and to help develop service delivery. However, progress in addressing identified issues had been slow, and some concerns identified at the previous assessment remained evident at this assessment.

Staff demonstrated an understanding of the importance of working alongside health and social care professionals to ensure people's needs were met. They described working with a range of external professionals, including district nurses, GPs and other healthcare services such as when a person showed signs of infection.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People's care records did not always contain the information and guidance staff needed to support them to manage their health and wellbeing effectively. For example, 1 person's records identified they had a catheter in place; however, there was limited guidance available for staff on how to support the person's catheter care. This meant staff did not have access to clear instructions to support the person safely and consistently. Additionally, daily care records lacked evidence that catheter care had been completed or monitored. This meant the provider could not be assured care was being delivered consistently in line with the person's assessed needs or that potential concerns would be identified and responded to promptly.

Staff were able to describe the practical support they provided to people and demonstrated an awareness of people's day-to-day health requirements. A visiting healthcare professional told us, "[Provider] had taken appropriate steps and actions to ensure people had been referred to health professionals."

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

People and their relatives told us they were not aware of care plans, and their care had not always been reviewed regularly, with several feeling they were overdue a review. One relative said, "[Relative] has had care for 12 months, with no review to date." This was reflected in records, where care plans and risk assessments had not always been reviewed or updated to reflect changes in people's needs. This increased the risk of people receiving care based on incorrect information and reduced the provider's ability to identify changing needs, adjust support accordingly and promote positive outcomes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The service did not always consider the Mental Capacity Act 2005 (MCA) when supporting people. For example, decision-specific mental capacity assessments and best interests decisions were not in place for a person identified as lacking mental capacity regarding their care arrangements. This meant they were at risk of their rights under the MCA not being respected.

Staff training records showed staff received MCA training and staff we spoke with demonstrated an awareness of the need to seek consent from people. One staff member told us, “Everything staff do they ask forconsentbefore. Wecan’tjust go into someone’s house and start doing things without their permission.”