Care 4 U Wolverhampton 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. At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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 were involved in their assessments and developing the care plans. A person told us, “I have a care plan which is reviewed regularly.” Staff told us they had information about people’s communication needs provided in care plans and could describe how this helped them to care for people. The registered manager worked with people, relatives and other professionals to understand their individual needs and preferences. The assessment was completed and used to form a care plan to meet individual needs. The plans included where people were supported by other agencies and health professionals and were reviewed when things changed. Records we saw supported what we were told.

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 confirmed staff were well trained and effective in their roles. A person told us, “The staff are very well trained and completely effective in everything they do.” The provider ensured staff had up to date information which was evidence-based through their training and development systems. Training was delivered by an accredited in-house trainer and was linked to best practice and care standards. The training was comprehensive and delivered to all staff. Staff could describe how this supported them to understand how to provide the support people needed. A staff member told us, “We have training to support people to maintain their health and wellbeing. For example, nutrition and wellbeing courses and we have Diabetes training is in place which enables us to help people to manage their conditions.”

The provider always worked well across teams and services to support people. The provider worked exceptionally well at ensuring the staff team worked well together and with other agencies. There were clear examples of joint working and partnership approaches to providing people’s care. Without exception all relatives we spoke with told us they felt as though the staff and management team worked with them to provide the best possible outcomes for people. We saw examples of how staff were working with other health agencies. This included working alongside personal assistants to provide care to people, specialist care agencies to jointly work packages, the fire service, independent living service, district nurses, occupational therapists and rapid intervention teams. Every person who was assessed to use the service was referred to relevant services if needs were identified. For example, referrals for fire prevention, including fitting smoke alarms were completed. Referrals for grab rails to help prevent falls were also carried out for people. People had positive outcomes from the joint working. For example, the provider had engaged the rapid intervention team when a person became unwell. Following this intervention the person was seen by a virtual ward, avoiding a hospital admission and receiving treatment at home. The provider was instrumental in liaising with the involved professionals to share updates on the person’s health and worked in conjunction with them to enable the person to recover in their own home. A staff member told us about how they were working with a person’s doctor to support the person to get their Diabetes under control and were able to share positive impact this had on the person’s health. The person was struggling to ensure information was collated for the doctor to monitor the persons health. Staff commenced monitoring and ensured the doctor was updated, which led to improvements and stability with the persons health condition. The registered manager shared examples of how they had worked with other agencies to provide support to people. The agency worked to support a 24-hour care package for a person where they worked together to provide a care plan which met the person’s needs across both agencies. Staff demonstrated how they worked to support the person alongside the other agency in their conversations with us. The registered manager told us the 24-hour care was nurse led, the main focus of the support from the agency was to offer a consistent staff team who understood the person’s needs and preferences and how the person communicated. Staff confirmed they worked with the person to communicate their wishes about their care and support. This person received continuity of care, and a holistic team approach was adopted whilst maintaining clear boundaries with the care the person received. The care plan defined the role of each agency and how the person’s needs were met. This meant the person received a seamless service from across both agencies.

The provider always supported people to manage their health and wellbeing to fully 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 their relatives described exceptional examples of how the staff and management team offered support which enhanced people’s health and wellbeing. Staff told us they had worked to deliver a range of activities designed to support a person with dementia. The person’s relative confirmed staff had introduced different activities to help stimulate their relative, such as memory games. Staff told us the different approaches they had introduced meant the person was calmer and had reduced anxiety. The person’s relative also felt the approach by staff had positively impacted their home life. We saw prompt actions to seek medical advice and alert relatives was taken when anything changed for people. Relatives confirmed staff were continuously alerted to any changes and always acted promptly to seek advice when needed. A relative told us, “If the staff have a concern whilst caring for [person’s name], they will always notify me straight away. We contact the doctor or a District Nurse, and someone comes out. This efficiency gives me peace of mind as I know that nothing will detract from their focussed person-centred care.” Where people had specific conditions, staff had received training which enabled them to provide effective support. Guidance was in place for staff to ensure they understood the persons health needs and how to meet them. The registered manager told us many people had improved health and wellbeing since using the service. They could share examples of how people’s health had stabilised when they began using the service. One person for example had been very unwell and in hospital when they began using the service. As a result, the person’s appetite and nutritional intake had been impacted, therefore the staff had supported them to improve their nutritional intake and the person’s health improved. Another person was able to stabilise their health condition through support with regular medicines administration. This meant people received support which improved their health and wellbeing and, in some cases, reduced their need for support totally as they regained their independence. In another example, the provider had worked with a local rapid access to social care team to seek support for a person who had become unwell and suddenly lost their ability to be independent. The provider worked with the local team to establish a care plan which was supported by a range of other professionals to improve the person’s health and avoid a hospital admission. A week later the person was able to return to independence with their original care plan in place. The registered manager told us they continually supported early intervention activities to give people the best possible outcomes. Staff were also able to share examples of how they supported people to access emergency health care. A staff member told us how they used the rapport they had developed with a person to enable them to access urgently required health care. The staff member said, “[Person’s name] refused a visit to hospital for a blood clot during the pandemic, I worked with the ambulance service and got permission to travel with them to get their treatment, this worked and they got better following my intervention.”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. People were consistently supported to improve and maintain their quality of life. People told us without exception how staff went above and beyond to help them to stay safe and have improved health and wellbeing. Relatives also felt their lives had been enhanced by the support their relatives received from the service. A relative told us having support from the service had made their life better. They commented, “The stress and work has decreased, it is now calm and we can have a predictable period, the staff are absolutely brilliant, I can come downstairs and now the whole tone and flavour of the morning has changed.” Another relative told us, “[Person’s name] has been with this care agency for years and always found them effective in every way throughout their changing care needs journey. The care plan has always been reviewed and updated when needed and adjustments always addressed.” Staff shared examples of how they had worked to improve people’s independence, health, nutritional intake and other areas of their lives to ensure they achieved better outcomes. A Staff member told us, “The care we deliver has made a visible impact on people’s health and wellbeing, we have a couple of examples where because of the high quality care, assistance and encouragement some people have been able to reduce or even cancel or postpone visits because they now feel well enough to manage independently. These are excellent outcomes for people who use our service and for Care 4 U too, instances like this make us feel proud of the service we provide.” There were regular reviews and updates to peoples care when things changed and staff were continuously monitoring people to ensure they received the right levels of support.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People had their consent sought before staff gave support. Most people had capacity to make their own decisions and had consented to their care. Staff understood how to seek consent from people, they had received training in the Mental Capacity Act and understood the need to assume people had capacity to make their own decisions, including unwise decisions. Where people lacked capacity to consent to some aspects of their care, there were individual decision specific mental capacity assessments in place with documented best interest discussions which had involved the relevant people.