Chadcome Healthcare Limited

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 service. This key question has been rated 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.

The provider made sure people’s care and treatment was effective by assessing their care, wellbeing and communication needs with them, however, not all health aspects were fully assessed. Initial assessments were conducted with people and their relatives where needed. Staff visited people at their home or in their care setting to discuss how they could be best supported. A person told us, “They came to my home and completed and assessment, I was asked enough questions and I told them what I wanted.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Nationally recognised tools were not utilised at the service. For example, the malnutrition universal screening tool (MUST) which assesses people’s nutritional risks. The Waterlow assessment, or a similar tool, were not in operation to establish if there were any risks to people’s skin integrity. Whilst the people being supported did not have any concerns relating to nutrition or pressure damage, the provider shared plans to expand the service and had not considered the benefits of nationally recognised tools to support safe care and risk mitigation. Following our feedback the nominated individual told us tools and templates were available and will be completed.

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. The nominated individual shared examples where staff supported people in line with professional advice, this included weight management and exercises. Although staff did support people to follow advice, recommendations had not been transferred into their care records.

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 were supported with meal preparation by staff who knew their preferences and likes. People were supported to reach and maintain healthy weights. The nominated individual told us how they encouraged people to take small walks, go out with family and enjoy their meals in accordance with recommendations.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. Outcomes were not always monitored to ensure they were consistent and met both clinical expectations and the expectations of people themselves. Although people told us they were able to direct the support they required as they wished, formal care reviews had not been routinely held to maintain records to accurately reflect their needs. The management team provided direct support to people and were knowledgeable about the care they required and their preferences, however, documentation did not support this.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People told us staff always requested permission before supporting them, however, formal consent was not documented. We reviewed a person’s care plan which stipulated they had increased confusion and advised they were not to leave their property unattended. A mental capacity assessment had not been completed to ascertain whether this was within the person’s best interest. We raised this concern with the provider to clarify the rationale behind the guidance, the nominated individual confirmed this was not a restrictive practice but the person’s wish. They advised they would rephrase the instructions in the care plan and revisit if the person requires any mental capacity assessments for specific decisions.