Tamworth Home Care 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 inspection we rated this key question requires improvement. At this inspection the rating has changed to 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.

People’s care records included the person’s voice within the assessment and the voice of their family members where necessary. People’s care plans were developed from an assessment of people’s needs. Care plans were regularly reviewed to ensure they reflected any changes in people’s needs or preferences.

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

At our last inspection concerns were highlighted in relation to people not being supported by consistent care staff and the quality of training staff had received. At this inspection, we found some improvements had been made however, further improvements were needed to ensure all people were supported by consistent staff who fully understood their needs. Comments included, “Our regular carer has become part of the family. The cover is not always consistent, although it has got better recently,” and “Some staff lack awareness of dementia and don’t know how to de-escalate situations when [Person’s] mood changes.”

Previously we identified gaps in the skills and knowledge of the staff member delivering training to care staff. At this inspection this had not been fully addressed. When we raised this, the manager acted and booked them on the appropriate Train the Trainer courses to address this shortfall.

The provider had made improvements and now used recognised tools to assess and identify risks to providing people’s care and support, including to assess the risk of skin integrity, risks related to constipation and catheter care including signs of SEPSIS.

The service worked closely with health and social care professionals to ensure they delivered care safely. Care records incorporated professional guidance given for staff to follow to ensure people’s care was delivered as directed and in line with evidence-based practice.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Some people and relatives felt communication between care staff and the office team needed to improve as messages didn’t always get passed on. There was also a delay in getting through to staff outside of normal office hours and voicemails were sometimes not responded to till the following day. A relative said, “It’s been a problem when twice I’ve rung and because it’s out of hours, no-one’s answered and the phone just rings and rings. You can leave a message, but they didn’t get back to me till the following day.” Other people were satisfied with the service provided and felt they were kept informed about any changes.

Staff told us the providers electronic management system [Birdie] enabled them to share information about people at each care call which ensured staff had the information they needed to make sure people’s needs were met safely and effectively.

Care records showed when healthcare professionals had been contacted to discuss a person’s care and the outcome of these discussions.

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.

A care co-ordinator told us how they reviewed people’s care call times and whether people needed the length of times they had. They told us 1 person did not require 45-minute calls and with consultation with the person and commissioners, some calls were reduced to 30 minutes, following a review of their needs.

Where people had specific health needs, advice had been sought from external health and social care professionals. For example, district nurses supported a person to manage their sore skin and another person with catheter care.

People’s care records contained important and necessary information to inform staff about people’s specific health conditions. Additional guidance sheets were available to enable staff to understand and support people who had complex conditions. This included how to support people in a positive way as well as signs to look out that could indicate a potential concern.

Staff told us they supported people to make healthcare appointments when needed. A senior staff member said they promoted good oral healthcare in the person’s home. Regular spot checks were carried out by senior staff on staff practice to ensure people received appropriate support to maintain their overall health and welfare.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Processes were in place to monitor the care and support people received. Where people had risks identified with their health, care plans detailed outcomes and any monitoring required to ensure their needs were safely met. For example, in relation to catheter care or skin integrity.

Staff were able to explain how they monitored people’s health and wellbeing to improve outcomes. Staff understood what action to take if they identified a concern. One staff member told us, “We have training in pressure care. At every call you look for any signs of redness or an actual sore. We make sure we reposition the person and check the mattress is working and fully inflated. You mark down everything you have done and if there is a problem say sore skin, you ring the office to let the seniors know so they can call the district nurse or the doctor.”

Where needed staff completed records to evidence the monitoring of for example, fluid intake and catheter care. This enabled staff to monitor people and identify if their need were being met or when a change was needed to improve an outcome.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us their choices were respected. One person said, “I tell them what I want, and they do what I want. They respect my wishes, also what I don’t want. They always say it’s your choice and it’s what you want.”

Care plans contained capacity assessments and where needed, for people assessed as not having capacity, decisions relating to aspects of their care were made in people’s best interests.

Staff confirmed they had received training about the requirements of the Mental Capacity Act 2005 (MCA) and demonstrated an understanding of its principles. One staff member told us, “You ask the client before you start to do things. If they declined, then I would have to ring the office to tell them. You can’t make the client let you do things."