Exceptional Care At Home (Barnet)

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 75 (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.

The provider carried out initial assessments in people’s homes before care packages were agreed, which helped them understand people’s needs, preferences and risks, and confirm they could provide appropriate support. Information gathered was used to develop person‑centred care plans and risk assessments, and to record background information important to people and their families.

Staff reviewed people’s needs on an ongoing basis and recorded changes in real time through daily notes, which informed updates to care plans and risk assessments. Systems generated alerts to prompt reviews, including following changes in needs, hospital discharge or increased support requirements. These methods were beneficial in ensuring care remained responsive and effective. This was reflected in feedback from people and relatives, for example, “[The Registered Manager] came to the house and discussed the package of care and explained everything.”

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 supported people according to their care plans and risk assessments, which were informed by input from professionals such as occupational therapists, district nurses and GPs where relevant. Staff followed these agreed care approaches in practice and adapted care in response to changes in people’s needs, including working with professionals to ensure appropriate equipment and support were in place.

Staff accessed up‑to‑date information and delivered care that was safe, appropriate and consistent with people’s needs. For example, staff applied training in moving and handling by using equipment safely, with a family member stating, “Carers are trained in using the hoist. New carers are shown how to use it.” This demonstrated that staff applied their training in practice to deliver safe and effective care.

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 in partnership with external professionals, including occupational therapists, district nurses and GPs, so people received coordinated care that met their needs. We saw examples of effective communication during transitions, including hospital discharge. The provider shared information in a timely way and care arrangements were agreed before people returned home. Staff communicated effectively with each other and management, and shared information in real time which supported consistent delivery of care.

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 supported people to attend health appointments and worked with healthcare professionals to respond to changes in health needs. Records showed that concerns were escalated appropriately. A person told us “Carers would help me if I was poorly. They would encourage me to contact the GP.”

Staff also supported people with nutrition, hydration and daily routines, and encouraged independence and activity where appropriate.

People and their relatives reported positive outcomes from the support provided, including improved wellbeing and reduced reliance on family members, which demonstrated that care was supporting people to maintain and improve their quality of life. A relative told us, “(The person) has improved as carers take (them) out”

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.

Leaders reviewed care‑visit data, care records, audits and feedback from people and used this information to assess performance and act where needed.

Leaders used audit findings to maintain high standards in key areas. For example, a risk assessment audit showed that all 143 people had a risk assessment in place, all were completed within a day of starting care and no reviews were overdue. Leaders monitored review cycles and identified upcoming demand, including 41 reviews due within 30 days, which supported proactive planning and helped prevent delays in reassessment.

Leaders also identified areas where oversight required strengthening. A staff spot check audit showed that, although a structured programme of checks was in place, recording systems did not consistently evidence completion, outcomes or actions taken. Leaders recognised this gap and planned improvements to strengthen monitoring and assurance.

Leaders reviewed feedback from people and their relatives alongside performance data to understand the impact of care. This showed that care was delivered reliably and supported improvements in people’s wellbeing, independence and safety, for example, a relative said, “(My family member) has made good progress with them.”

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

The provider obtained consent from people before delivering care and supported them to make decisions regarding this. Staff understood the importance of gaining consent and worked in line with people’s preferences, ensuring care was provided in a person‑centred way.

People and their relatives told us that staff asked for permission and explained what care would involve before providing support. Staff respected people’s choices and adapted care accordingly. Records showed that people’s views and preferences were reflected in care plans and daily practice.

Staff received training in the Mental Capacity Act 2005 principles and were able to describe how they would escalate concerns where people may lack capacity to make decisions. This demonstrated a consistent approach to ensuring care was delivered in line with people’s wishes and legal requirements.