Firstchoice Consultancy Ltd

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

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 71 (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 they carried out an assessment of people’s needs prior to the provision of care and records confirmed this. The assessment involved the people and their relatives where appropriate, so it captured what was important to them. People we spoke with confirmed they were involved in planning their care which involved managing any risks to their safety. A person told us, “I have been involved in care planning and reviews. The registered manager often phone or text me to ask if I am ok.”

The registered manager told us a review of care plan reviews was carried out on a yearly basis or as and when required, to reflect on the changes and support required.

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.

The care plan we reviewed clearly provided a good overview about person’s communication, mobility, dietary, nutrition and hydration needs including deciding menus, food allergies and the level of support required. A person said, “I am learning about Nigerian cooking with my carer. They are also learning about English food. We have fun learning each other’s cooking style.”

People was supported to attend annual health checks with their GP, ensuring potential health concerns were identified early. Staff also ensured people accessed routine appointments with GPs and physio therapist when required. This proactive approach meant people’s physical health was monitored and maintained, contributing to improved wellbeing and overall quality of life.

Policies were in line with national good practice and care was given in a person-centred way, in line with the persons wishes, and they were involved in the care planning process.

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 they moved between different services.

The registered manager maintained an effective communication with people using the service and staff. The registered manager told us, “On Away Day, staff discuss about person’s health and wellbeing including changes, and concerns.” A staff told us, “The registered manager is very good boss. They are very keen about their staff and the person. We regularly discuss about person needs and support requirements. Things get sorted quickly. They do not take a second to address the problems”.

The staff we spoke with, demonstrated a good awareness of people’s health and medical needs and, how they would respond to these, if people were to become unwell. Staff had been supporting people to attend their healthcare appointment. The staff had access to the information they needed to appropriately assess, plan and deliver person’s care and support.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported the people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported by staff to stay healthy and well in line with their assessed needs. People’s wishes were documented in their care plans. The care plan we reviewed, clearly highlighted the support the person using the service required and how staff can meet those needs.

Staff were aware of people’s health diagnosis, dietary requirements, lifestyle, mobility, and spiritual needs. Staff encouraged people to access their local community where this was part of their planned care and support.

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, or that they met both clinical expectations and the expectations of the person themselves.

On our visit, we reviewed the daily log notes completed by the staff on each visit. We found that they were not detailed. They lacked vital information including the type of support provided during personal care and what the person had for their breakfast and lunch. The availability of such information, like dietary intake, can help healthcare professionals to identify themes and trends and recommend further lifestyle changes to maintain independence and live a healthy life when required. We discussed this with the registered manager, and they assured us detailed information would be recoded on daily basis.

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

Care plans included an 'Agreement Form' which stated, "I have been involved in drawing up this care plan. I give my consent for the care to be provided as described in the care plan." This form had been signed by the person which showed they were involved in making decisions about the person's care”. The registered manager informed us that person using the service has mental capacity.

Records showed people were involved in decisions about their care, which helped them to retain choice and control over how their care and support was delivered. For example, they were supported to choose the time of staff visits to support them with their needs.

We spoke with staff and they demonstrated a good understanding about the importance of person’s consent. A staff member told us, “I do not do anything for the person without asking them.”