Thames Homecare Service 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.

At our last assessment we rated this key question good. At this assessment the rating has changed to 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.

Whilst people told us they had their needs met, improvements were required to ensure care records contained enough up to date information, for staff guidance. For example, we found a person's record contained conflicting information about their continence needs. This was brought to the attention of the manager during our assessment and was rectified immediately. Another person's care plan gave some detail about their mental health and how this affected them. However, this lacked guidance for staff about how they support this person when they are experiencing symptoms. We also found a person's care plan lacked detail about their learning disability, and how staff supported them with this on a day-to-day basis.Following our assessment, we spoke with the manager about records concerns, they assured us and provided evidence of a new care planning system, which would improve people’s assessments and care records.

The provider did not always plan people’s care and treatment with them. Records did not always contain up to date advice from external professionals. Whilst we found some people’s care records contained information from professionals involved in their care, such as speech and language therapy information, improvements were required to ensure all records contained enough information. For example, 1 person's care plan did not contain information about their use of continence aids. Another person's care plan lacked detail about how staff monitored their diabetes and what action should be taken in the event of an emergency.Staff knew people well and people told us staff supported them in line with their assessed needs. Following our assessment the manager assured us care records were being audited, updated and new care planning systems were in place.

The provider worked well across teams and services to support people. We received positive feedback from partners who worked with the service, they told us staff worked well with them and communicated effectively with them. A professional said, “The Manager has been nothing short of excellent when supporting me with issues, attending meetings and joint visits to people. They will do their utmost to support and will also put in preventative measure so that risk of harm is reduced. The team, are flexible with their working and I always feel that both my clients, and me as a professional, are in a safe pair of hands when Thames Homecare pick up a care package.” Staff told us the morale within the team was good and the provider had mission statements in place, which included providing safe care, safeguarding people, teamwork, work life balance and achieving good outcomes for people. A staff member said, “I enjoy my work, the manager supports us all.”

Whilst we found people had access to external professionals as required, such as district nurses administering insulin for a person and emergency services, improvements were required to records. This was to ensure they contained enough information about how staff supported people to live healthily. For example, 1 person’s care plan stated they ate a healthy diet. However, there was little detail about how staff supported the person to achieve this or what kind of foods could be offered. We also found a lack of detail about how staff supported this person with their foot care, to enable them to mobilise without pain. External professionals told us the service worked well with them to meet people's needs and we saw evidence of staff working with professionals. This was a recording concern and we were assured by the manager this was being addressed following our assessment.

People told us they achieved good outcomes, and records evidenced people had positive outcomes. For example, when a person had requested assistance with their living arrangements, staff had supported them to access the correct services. Another person was supported to attend English language lessons. However, some improvements were needed, to ensure people's care plans contained their future goals and aspirations.

The provider did not always tell people about their rights around consent. Some improvements were required to ensure the provider followed the principles of the Mental Capacity Act (MCA). Some capacity assessments had been completed for people. However these were not robust and did not evidence how staff had appropriately assessed people capacity to consent. There was also a lack of best interest decisions, where people were deemed to lack capacity. This was discussed with the manager during our assessment and we were assured these records would be put in place. Staff had received training in relation to the MCA and understood their responsibilities to gain consent from people. A staff member said, “I involve people in their care and decisions. I respect people’s choices, and maintain their privacy and confidentiality.” Relatives told us staff asked for their loved one’s consent prior to supporting them. A relative said, “The best thing is that [staff] care, they come and have a chat and make [name] feel included in everything”. Having staff who can speak Somalian has been so nice and really important for [name]. They make cups of tea and have jokes.”