The Care Bureau- Home Support Service

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 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 assessed people before a service was provided. Those assessments included the person and any family members or their representatives. It was evident from care plans, people’s involvement and wishes in what they needed formed an important part of people’s information for staff to follow. The assessment process included a review of any specialist equipment needs and how many staff would be required to support people.

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.

One relative told us how staff had supported their family member when they had a health condition that needed close monitoring. This relative said they were involved from the start of the care package, and they worked closely with visiting staff.

Most people we spoke with, or those who we followed their journey through the service, made their own meals or had family that supported them with this. Where people had swallowing issues that put them at risk when eating and drinking, even when staff may not be supporting with this, it was clearly recorded in people’s care plans. This ensured staff had the knowledge they needed if they were asked to support with nutrition and hydration in an emergency. Additionally, this helped other health professionals.

The provider did not always work 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 registered manager felt communication was effective because the staff team was small, meaning communication with the entire staff team helped build positive and stronger relationships through clear messaging. The registered manager said they had good relationships with people’s GP and other health professionals, as well as commissioners. However, staff we spoke with felt if they raised anything internally, it was not always remembered or acted upon. It was clear from our office visit and hearing from staff there were differences across both provider’s services, which staff did not necessarily understand or that made them feel as valued as others. We discussed this with the registered manager after our visit so they could consider this.

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’s care records included information about their health conditions, but also, what was important to them. Care packages supported people with achieving their goals, ambitions and what was important to them. In 1 example, staff worked closely with 1 person to make lifestyle adjustments which would improve their overall health and welfare. This was achieved. We spoke with this person and asked them what difference the staff made to them. This person said they were now proud of their home and wanted to continue to improve it. One staff member said they helped people to socialise and widen their friendship network because of the positive support received from staff.

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.

One relative was complimentary about the care, support and friendship they felt from staff who supported their family member. This relative said staff were good at knowing and monitoring their family members condition, as well as knowing the person and working with them in a way they responded to well. A person receiving a service said staff were great, “I give them 100 out of 100.” This was because staff knew them and always checked with them, what they wanted to do and what they wanted to achieve though working on things together.

Staff were confident they knew people well because they looked after the same people. We spoke with staff about one individual who needed close monitoring of a health condition. Staff understood why, what to do and completed records to help other health professionals in case they needed to make clinical decisions.

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

The registered manager and staff understood the importance of consent and assuming people had capacity to make decisions about their care and support under the Mental Capacity Act 2005 (MCA). Managers understood their responsibilities to protect people's rights and what to do when someone might not have the capacity to make their own decisions, so decisions made on people's behalf were made in their best interests. The provider kept copies of Power of Attorney (POA) documentation so they could liaise with the correct representative for health and financial decisions. The registered manager said they followed these, especially when families were involved so they sought the right individual’s involvement.

At the time of our assessment, each person receiving a regulated activity had their capacity assessed so they were involved in some or all aspects of their care where they had understanding. Staff understood which decisions people needed support with, so they were still involved in their care delivery. Reviews of people’s care was with their consent and support.