Homecare Solutions For You

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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.

If this is the first rating of a service state: This is the first assessment for this. This key question has been rated Requires Improvement.

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 46 (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.

Care plans were not consistently reflective of people's current needs. Although some improvements were made during this assessment, further detail was still required, particularly regarding moving and handling, stair use and the level of family involvement.

Reviews were not always meaningful. For example, we reviewed one person's care plan which had been marked as reviewed January 2026 but contained out of date information such as stating the person lived downstairs when they lived upstairs. Care plans did not always contain a complete list of people's medicines or equipment they used.

Guidance for staff around moving and handling lacked sufficient detail, and instructions for two-care staff tasks and did not clearly outline the responsibilities of each staff member. Care records did not consistently evidence support with oral care or hair washing and care plans were not detailed about the level of support people required.

People told us that they felt listened to during the initial assessment, one person told us, "We sat and completed (relative’s) care plan together, we were really listened to”. However, there was insufficient management oversight of ongoing assessments and care planning. As a result, we could not be assured people consistently received safe care that met their individual needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Care plans for people with specific health conditions lacked sufficient detail and did not provide staff with clear, evidence-based guidance aligned with best practice. Staff were not consistently recording care notes to demonstrate the care delivered.

The management team did not always apply, national standards or evidence-based frameworks such as NICE guidance when planning and reviewing care. The service did not use recognised clinical assessment tools, such as the waterlow score (a tool used to assess people's risk of developing pressure ulcers), to identify and monitor pressure ulcer risk. While no one currently had a pressure ulcer, people were assessed as being at risk of developing pressure ulcers.

Tissue viability assessments were not consistently reviewed, with one assessment not reviewed since 2024. This meant we were not assured people's changing needs were being appropriately monitored and supported.

The provider did not always work well across teams and services to support people.

Care plans were not always clear, up to date or sufficiently detailed to support effective coordination between staff and external professionals. Some care plans contained excessive information whilst others lacked essential detail, such as list of equipment or clear guidance how people should be supported with transfers. Records and assessments sometimes contained out of date or irrelevant information, making it difficult for other agencies to understand people's needs.

Staff did not always have the necessary information in care plans or risk assessments to mitigate risks or reliably deliver care and support in alignment with people's current needs. This limited the ability of teams and partner organisations to work effectively.

Despite our findings people told us, that when other agencies were involved, they felt the services worked well together.

The provider did not always support people to manage their health and wellbeing to maximise their independence, choice and control.

Care plans showed inconsistent information about people’s health and support needs as well as levels of independence. In some cases, preferences were clearly recorded, for example a person requesting Gujarati female staff or where a person would wash their upper body independently but require support with other areas of personal care. However, in other care plans no preferences were recorded, and the level of independence or required support was not identified. This limits staff ability to promote people’s health and autonomy in a consistent way.

Despite our findings, people and their relatives did not raise concerns about how staff supported them with their day-to-day support needs. Feedback we received indicated that staff were kind and willing to help, but the variation in care plan details meant this was not reliably embedded across the service.

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.

Care records did not consistently evidence that people's health and wellbeing were being monitored. There was limited information to demonstrate that staff and leaders supported people to understand and agree what good outcomes would look like for them. There was no effective system in place to track people's needs and risks.

There was a lack of oversight of incidents and accidents, this meant patterns or trends may have been missed and opportunities to improve the service were not always identified. Despite our findings people and their relatives spoke positively about the care provided. One relative told us, “They really care for (relative) the improvement in them is noticeable since having regular carers”.

The provider did not have a robust approach to monitoring the effectiveness of care, treatment and support to drive continuous improvements. When our findings were discussed during this assessment the provider informed us, they would update their audits to make them more effective for the service.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

There was a lack of understanding and application of the Mental Capacity Act (MCA,2005). MCA assessments had been completed for all people, including those for whom there was no reason to think they may lack capacity. This indicated a blanket approach rather than personalised and decision specific assessments. For one person who did require an MCA assessment, it had not been completed appropriately as environmental factors were not considered; the person had not been asked any questions; it was not decision -specific and they had not had their capacity re assessed. Additionally, there was no best interest decision in place.

Care plans were unclear about whether people had full capacity in relation to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and DNACPR status was not consistently recorded. Consent was obtained for care delivery but not for specific aspects in relation to care delivery such as sharing information with and involving family members in regard to people's care and support.

These shortfalls meant people were at risk of their rights being restricted without lawful justification or appropriate safeguards. One relative told us, "Yes, my (relative) does have a DNR but I am not sure if the carers know about this; it is stated in their care plan which was discussed and completed with me. My (relative) was present.”