Light Care Services Limited Hampshire

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• 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 not been fully assessed, therefore an overall rating for this key question can not be given.

We reviewed 2 quality statements for this key question. Leaders told us people’s needs were assessed before care packages were agreed and the completed pre-assessments formed the basis of people’s care plans. However, the care plans we looked at were not reflective of people’s current care and support needs. This meant we could not be assured staff had been provided with clear and detailed information about people’s needs and how to manage these effectively.

The leadership team had failed to identify care records lacked detail about people’s specific needs, and information was incorrect and contradictory. The lack of detailed information and guidance provided to staff put people at risk of receiving inappropriate or inconsistent care.

Although leaders described action they would take to share concerns with professionals in a timely why should concerns or issues arise, we are unable to establish if this was always done due to poor documentation and incomplete records. Lack of processes in place meant we could not be assured the service worked effectively with partners or that support from external healthcare professionals was requested in a timely way.

Leaders and staff did not have a clear understanding of the mental capacity act and how this should be applied to ensure people received safe care and support to meet their specific needs.

This service scored 8 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We were told by the leadership team that people’s needs were assessed before care packages were agreed and these assessments were carried out face to face. However, we received mixed views from people and relatives about the staff’s skills and awareness of people’s individual needs. For example, one relative said, “We do have a care plan now after the commencement of the service, however its very clear complex care is not understood by the carers and the company.” Another relative told us, “I do understand that carers are not medically trained but they should have a brief overview of someone’s medical condition and an idea of what it is like to live with that condition, so they are better placed to help that person.” A person said, “They will mash up all my food and I have told them not to, I have no teeth but can manage soft food.” Another person told us, “I have a care plan that I was involved with.”

There were no records of any nationally recognised tools used to assess people’s needs, such as skin integrity assessment tools. This meant we could not be assured people’s needs were robustly assessed to help ensure they always received continued and safe care.

A member of the leadership team told us, the completed pre-assessments formed the basis of people’s care plans. They added, “We agree visits and call times with the client and their family, but we are keen not to over promise what we cannot deliver” and “We then brief the carers and tell them to read the care plan.” However, the care plans we looked at were not reflective of people’s current care and support needs despite people receiving care for periods of up to 11 months. Therefore, we could not be assured staff had been provided with clear and detailed information about people’s needs and how to manage these effectively.

We could not be assured leaders and staff had a clear understanding of the mental capacity act and how this should be applied to ensure people received safe care and support to meet their specific needs. A staff member told us they did not carry out mental capacity assessments but were involved in best interest decisions with members of the multi-disciplinary team. However, none of the care plans we reviewed contained any documentation relating to best interest decision making.

The leadership team were unable to demonstrate there was effective processes in place to ensure people’s needs were regularly assessed and changes in care needs would be appropriately managed. Although the leadership team told us, care plan reviews took place, there was minimal documentation to show what was discussed and changes in people’s needs had not resulted in care plans being updated to reflect any changes in people’s needs.

The leadership team had failed to identify care records lacked detail about people’s specific needs, and information was incorrect and contradictory. The lack of detailed information and guidance provided to staff put people at risk of receiving inappropriate or inconsistent care.

Records also lacked detail on how people had been involved in care planning and reviews and did not provide assurances that when there was a decline in people’s health and wellbeing support was requested in a timely way from health or social care professionals as required.

We did not look at Delivering evidence-based care and treatment during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

We received minimal feedback from people and relatives about how staff, teams and services work together. However, a relative told us, “They [staff] monitor [person’s] skin and also got the district nurse to change the type of pads used which are more comfortable for them.” Another relative told us, “The carers are flexible as I asked them to come early when [person] had a hospital appointment last week to get him ready for the transport and they did this.” Although these positive comments were received, we could not be assured this happened consistently as there were no systems in place to guide staff how or when staff should work across teams.

Although leaders described actions, they would take to share concerns with professionals in a timely way should concerns or issues arise, we were unable to establish if this was always done. Therefore, we could not be assured the leadership team worked well across teams and services to support people.

We found in some areas, the service worked effectively across teams and services to support people, but not all. This was because information about working across services was not held within care plans but was held in emails meaning not all staff had access to required information. For example, it was unclear how the service sought advice and agreed appropriate care with the diabetic team in relation to one person’s blood sugar levels or with an occupational therapist in relation to one person’s mobility and pressure relieving equipment needs, because nothing was documented in the care plan.

Due to serious issues which had been identified by outside agencies and stakeholders in relation to the employment and treatment of staff from overseas there had been an increased oversight of the service by all agencies including health and social care professionals. Prior to these concerns being identified the provider failed to work effectively with professionals and stakeholders. During our assessment we received correspondence from professionals who had been working closely with the service. These professionals continued to have concerns about the overall running of the service including information they had been provided with from the leadership team regarding the services action plan in relation to staffing and rotas and conflicting information being given to staff working for the provider from overseas.

A member of the leadership team told us that working with the local authority had been very useful despite the circumstances. They explained how the service had put in place a new email address just for professionals and clients to make contact. This had been effective immediately and they told us it had improved communication between services.

Lack of processes in place meant we could not be assured the service worked effectively with partners or that support from external healthcare professionals was requested in a timely way. From the information provided and reviewed we could not be assured people were provided with care in line with their assessed needs or that staff followed guidance given by specific health professionals. This placed people at risk of harm.

We did not look at Supporting people to live healthier lives during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

We did not look at Monitoring and improving outcomes during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

We did not look at Consent to care and treatment during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.