suite B, 1st Floor Shaw House 2-3 Tunsgate Guildford Surrey GU1 3QT Also known as Office

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 newly registered 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 67 (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.
People told us they felt involved in their care planning. One person said, “I would say the care plan is basic, but I have been regularly asked whether I’m satisfied with the service and asked if I need anything else.”
Another relative told us, “The care plan also includes maintaining hygiene in her room and bathroom. There are two reviews a year, they go through a checklist and give the opportunity to fine tune the care.”
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.
We found for 1 person their medicine was being broken into pieces before being administered. This meant the provider was not administering this medicine in line with the prescribers’ instructions or best practice standards. Therefore, we could not be assured that the medicines they were administering were having the desired therapeutic effectiveness.
Another person was noted to have barrier cream applied to a wound. We found the staff entry noted, “[Person] has a small cut in [their] groin for which I applied barrier cream. [Person] says it is causing pain and [person] flinched every time I touched it.” However, we did not find supporting evidence this was carried out under guidance from healthcare professionals. This meant staff within the service were treating wounds without proper care plans in place.
Care plans included information about supporting people with meals and drinks, skin integrity and medicine administration. People and relatives told us they felt involved in care planning and delivery. One person told us, “The morning visit includes getting my breakfast; they offer to cook but I don’t want that, I have my choice of breakfast. They make sure I have a drink with me when they leave.”
 

The provider worked well across teams and services to support people. Staff told us about the daily huddles held with management to discuss people’s needs and other topics such as policies and training. One staff told us, “The daily huddles share any changes to clients, as well as a notification sent to every staff member. It must be read and the app highlights if we have or have not read it.” The registered manager also said, “Daily huddle is our sense of unity; you get to know staff. We do take time to meet up for lunch if we can. We take time in celebrating achievements .”
We contacted healthcare partners the service worked with for feedback however we did not receive a response.
 

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 and relatives told us how staff supported them to live healthier lives. One person said, “They give [person] all [their] meals, which includes encouraging [them] to eat well.”. Another person told us, “They take [person] out for a walk every morning. I feel [their] care is shared between me and the carers, in fact I struggle with understanding dementia, and I depend on phone contact with (named person at office) for advice and ideas.” This demonstrated people and relatives felt supported and worked together with the provider to support people to manage their health and wellbeing.
 

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 and
consistent, or that they met both clinical expectations and the expectations of people themselves.
We found some people’s care and treatment needs were not responded to without delay. For example, one person with symptoms of a urinary tract infection experienced a delay in the onset of symptoms and then obtaining antibiotics. Although the provider contacted the GP to support this person, the communication record between staff demonstrated gaps in monitoring these symptoms. This meant provider did not always ensure people received care and treatment without delay to ensure outcomes were positive and clinical expectations were met.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We found the provider completed mental capacity assessments and best interest decisions where required.
People and relatives told us, “Everything they do is with my consent” and “They are very respectful and always ensure [person] understands and consents to their care.” Staff we spoke to had good understanding of seeking consent prior to delivering care. One staff said, “We assume everybody has capacity to consent and be aware that we are doing things in their best interest.”
Staff we spoke to had training and could evidence to us their understanding of the Mental Capacity Act 2005 (MCA) and how they supported people's right to make choices. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. We found MCA and Best Interest decisions were completed when needed. Where people required support to consent and make decisions and a Lasting Power of Attorney (LPA) was in place, consent had been given by them. Care plans included clear documentation of each person’s capacity and the level of support they needed to make informed decisions. Where support was required, decisions were made in the person’s best interests, involving appropriate professionals and representatives. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. At the time of assessment, there were no restrictions in place.
One staff told us, “I must ask in people’s best interest. If I am supporting who lacks capacity to agree to certain things, I carefully explain to them what it is that I am doing and give them time to understand what it is I am proposing to do.”