Utopia Care 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.
This is the first assessment for this service. This key question has been rated Requires Improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. The service was in breach of legal regulation in relation to consent.
 

This service scored 62 (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. People’s ongoing health needs were not always escalated and monitored. For example, staff recorded bruising in a person’s care notes. We could not see that this was followed by ongoing monitoring, or involvement of other professionals, and there were no further entries in the daily notes showing how this had progressed. However, care plans we reviewed were written in first-person voice and structured around identified needs, planned outcomes and risk scoring. People described being central to the assessment process. A relative explained that "Their [relative] care plan was reviewed 6 weeks after the care started". A person said, "The carers really listen to me, and they have read the care plan, which is good and understand my needs".
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. While staff kept detailed notes on people’s care, and we could see that the provider carried out frequent reviews, these did not always translate into prompt action, and changes to people’s care in response to risk. A care plan reviewed referenced clinical guidance, including the correct application order for emollients with timed gaps, fire safety guidance for paraffin-based products, and post-hip-replacement transfer precautions. People described care being delivered to their preferences. A relative stated, "Food and drinks are prepared to their liking". A person told us, "My personal care is done well and to my liking". The provider applied risk scoring consistently across all care plans, supporting evidence-based prioritisation of need.

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. The provider worked with external healthcare partners. A relative told us, "The carers are very good at working with local GPs and social services and have a good relationship with them to get things done… when they [relative] were unwell, they arranged a visit from the GP and they were prescribed antibiotics". A person told us, "They did call for a paramedic as I was unwell, and I was given antibiotics". Care plans evidenced multi-agency working with district nurses, memory clinic professionals, social services and occupational therapists. Internal handovers between carers were structured around the electronic care system. Information about service users' needs was shared at each visit, supporting continuity of care across different carers.

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. A person with diabetes explained "they check my feet and understand my dietary requirements” and described how "with their support I am able to live independently". Another person stated, "having the carers call twice a day allows me to live independently in my own home". People were enabled to retain skills: a person explained: "They will also allow me to do things for myself, for example, shower, but they are there if I need them". Care notes consistently recorded and celebrated independent activity, for example, when a person had buttered his own sandwich, used the microwave, or changed [their] own continence pad before the carer arrived. The provider treated independence as the goal of care rather than a constraint on it.

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. A relative described an increase in support following a reassessment: "They [relative] had 1 carer at each call, and recently the calls have been increased to 3 after a review of care as their mobility and health have declined". Another relative reflected on the longer-term outcome of the support provided: "With their support, they [relative] is less stressed, and their mental health has improved", adding that "they tick all the boxes for what was promised at the start of their care package". A person told us, "The manager will phone me to ensure all is well", confirming a routine of management contact to monitor satisfaction with care. Outcomes met both clinical expectations and the expectations of the people themselves.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. Mental Capacity Act 2005 (MCA) processes were not consistently applied. Formal capacity assessments and best interest decisions were absent where required, and documentation contradicted assessed capacity. While carers sought verbal consent at each visit, governance arrangements did not ensure lawful consent was consistently evidenced. None of the care plans reviewed referenced a formal mental capacity assessment having been undertaken. The service was in breach of legal regulation in relation to consent to care and treatment.