CRM Healthcare Solutions 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 – 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 newly registered 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 63 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The provider did not always regularly review people’s care and support plans. For example, one person’s care needs had significantly changed, and this had not been reflected in their care plan or risk assessment. Guidance for staff outlined the use of equipment that was no longer safe to use until a further assessment was completed by a physiotherapist and occupational therapist. Staff were knowledgeable in how to safely support the person but there was a potential risk that any new staff would not have the correct guidance in place.

Risk assessments were not always in place where needed. For example, one person who was at risk of pressure damage did not have a risk assessment in place.

Actions taken around the management of skin integrity were not always necessary and proportionate based on the person’s assessed need and risk. For example, the provider instructed staff to take pictures to evidence skin integrity at each care visit, this included for people where there was no risk in relation to their skin or pressure areas. Staff told us this made them feel uncomfortable as it did not feel dignified for the person they supported.

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.

Staff followed advice given by healthcare professionals to ensure best practice and positive outcomes for people. This included exercises under the instruction of physiotherapists.

Staff supported people with their nutrition and hydration needs and records included their likes, dislikes and their daily intake. However, one person who was at risk of choking was not being supported safely and had not been appropriately assessed. The language used to describe the safe food for that person was not in line with best practice guidance outlined in the International Dysphagia Diet Standardisation Initiative (IDDSI). The provider took action to address this immediately when we provided feedback as part of the assessment by making a referral to a speech and language therapist.

The provider worked 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.

Staff told us that as carers they worked well together as team to ensure people’s needs were met. Care records did not always provide up to date and detailed information and guidance for staff. However, staff knew the people they supported well and there was good communication between the team and from leaders when there were changes in people’s care needs and so this did not impact the care people received.

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.

Staff were knowledgeable and had a good understanding of the people they supported. Daily care notes were person-centred, in-depth and provided good insight into the care provided and people’s holistic presentation during the visit. Staff reported any concerns they had about the people they supported for action to be taken and on-going monitoring.

One relative said, “The carers will promote independence by letting my relative wash herself whenever possible”.

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.

The provider had good oversight of the people they supported, and people had made positive improvements since receiving support. For example, one person who had not accessed the community for several years, did so after building a relationship and trust in the staff supporting them. Staff recognised their personal interests and used these as motivation to achieve positive outcomes.

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

Staff had received training around capacity and consent and were confident in putting this into practice.