Affinity Trust- Domiciliary Care Agency- Central

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 remained 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. The registered manager told us people’s needs were assessed when they started to use the service, and these were used to inform care plans and risk assessments. The assessments were undertaken with input from the person and their representatives, where appropriate. Where people were unable to contribute to detailed planning, relatives confirmed they had been involved and consulted alongside health and social care professionals involved in the person’s care. People’s care plans included assessments of their needs, wishes and aspirations to ensure the service was able to meet these. Staff developed support plans with people which focused on what was important to them and goals they wanted to achieve. They supported people to assess they were happy with their tenancies and understood their rights and responsibilities.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People and their representatives, where appropriate, were involved in the planning of their care. One person told us, “I read my care plan, and I’m involved when it’s reviewed. Staff ask me if I would like to add to it or change anything. ”People’s records included the support they required with their food and drink. Most people were happy with the support they received. A person told us,“ Staff do my favourite dinner. I have chocolate as a snack and drinks. I help myself.” A staff member described the importance of encouraging people to eat a well balanced diet. They told us, “[Name] has a full fridge of fresh fruit and food. All meals are cooked fresh daily.” Some people and relatives felt some staff were not knowledgeable in how to prepare traditional British food. A relative told us, “They tried to cook [Name] a chicken casserole once. They hadn’t a clue how to do it. They don’t understand about portion sizes and [Name] was putting on weight as they were enormous portions. We told the manager, and a plan is in place to eat healthy meals and portioned controlled. They listened.” The provider had recognised some staff needed further training and support to understand food and culture that was important to people and had begun to implement training to address this specific 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. People’s care plans included their life history and experiences, what and who was important to them and their ambitions and goals. This helped people to tell their story and have their needs met consistently and safely. Staff shared relevant information and worked with external health and social care professionals to ensure people’s needs were understood and their wishes heard. For example, where people wanted to live and how they wanted to spend their time. This helped to ensure people had the right support in a timely way.

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 told us if they needed support to access health care support this would be provided. One person told us they had been to their GP on that day supported by their staff. Their staff member told us, “We went to see the GP today as a precaution. Due to [Name’s] health needs, we need to act when we notice any changes or possible health complications. Everything was fine,[Name] just got a check over.” Staff had recorded information about people’s healthcare needs in assessments and care plans. They shared guidance and information with staff about how these needs should be monitored and met. People and relatives told us staff supported them to access external healthcare services, including routine healthcare and specialist services. People were supported to maintain relationships with family members and friends who were important to them. Relatives described how staff supported their family member to keep in touch through technology, including mobile phones and social media. Relatives described how staff had arranged home visits as they were no longer able to travel which meant they still had face to face contact with their family member. Relatives confirmed they could visit when they wanted, with the person’s consent. This helped people to maintain their emotional well being.

The provider monitored people’s care and treatment to continuously improve it. They strived to ensure outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. However, further improvements were needed where shortfalls were identified. We found lessons were not always learnt and disseminated to staff to reduce future risks in a timely way. For example, effective monitoring to support timely actions and improvements for people who experienced distress was not consistently embedded across all services. The registered manager acted on our feedback following our inspection visit. We received mixed feedback from people’s relatives around outcomes and monitoring of people’s care. Where people achieved positive outcomes, feedback was very positive. Relative comments included, “Since Affinity staff have been working with [Name] they have made considerable progress. Every staff member understands how important personal care if for [Name]. Name] has now started to be involved in getting dressed independently. This never happened before. I take my hat off to the staff,” “For a long time [Name] refused to go outside; now staff have got [Name] going out, going to the shops with a phone; they've trained him up,” and “[Name] needs help to keep clean. Staff have come up with a really good system to help [Name] get into the shower. With persuasion, [Name] is now enjoying their showers. ”Relatives who felt people were not always supported to achieve consistent outcomes attributed this to inconsistent staff support. Comments included, “They are not mental health trained and cannot do Makaton. They could use emojis but don’t bother” and “There is inconsistent care ,and this means I have to keep reminding staff of basics, like cutting nails and ensuring dignity before activities like swimming.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People consented to their care and treatment. They confirmed they were offered choices and these were respected. People were asked to agree and consent to care plans. Mental capacity assessments required further development to ensure these were decision specific rather than assessment of generic areas. The registered manager told us they would address this following our inspection visit and the provider had already begun to implement more advanced training to make improvements. Some people lacked the mental capacity to make certain decisions about their care. The registered manager assessed these and consulted with people’s representatives and followed legal authorities to help ensure decisions were made in their best interests. We observed staff respected people’s choices and decision during our inspection visit. For example, we saw people demonstrating choices as to where and how they wanted to spend their time and when they wanted to engage with staff. Staff respected this which demonstrated people were involved in choices about their care.