BG Healthcare Cumbria Branch

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• 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 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 service did not always ensure people’s needs were assessed effectively.

Where people had diabetes which they managed independently or through staff support, care plans did not always include enough guidance for staff to identify symptoms of adverse health relating to the condition. When we informed the registered manager, they sent us evidence of how they reviewed 1 person’s care plan which now included this information. Some care plans required clearer information about how people wished to be supported to take their medicines.

People and their relatives generally felt involved in the care planning process however some people reported they did not have a copy of their care plan.

The service 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 service worked with health and social care professionals, where required, to ensure support was provided in line with people’s assessed needs.

People received effective care in line with what mattered to them that followed best practice guidance.

People’s care plans included a range of best practice assessments such as MUST (Malnutritional Universal Screening Tool) and Waterlow (used to assess risks of developing pressure ulcers). These were used to develop person centred care plans.

Care plans provided detailed information about people’s dietary, nutrition and hydration needs including preferences, and the level of support people required.

Staff were trained, competent and used evidence-based approaches.

The service 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 people moved between different services.

Staff told us they worked well together. One staff member told us, “The team is really supportive and cooperative.” Another staff member told us, “The [service] is the best, whenever I need anything at work, colleagues help out.”

Staff recorded and discussed information about changes in people’s needs, and this was shared with the rest of the team. The management team ensured any tasks such as appointments were followed up in a timely way.

The staff team worked well with external services.

The service 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.

We saw evidence the service sought support from healthcare professionals when they identified people could benefit from this. When people were unwell, records showed that staff facilitated access to the GP or other health partners quickly. One person told us told us, “[Staff] do everything well. When I have a health issue, [Staff member] takes me to see the nurse.”

The service 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.

People’s daily records generally included clear and concise information which could be used by the service and external health and social care professionals to review their care or make decisions about how to meet changes in needs. For example, where appropriate, changes in people’s mobility needs or skin condition had led to increased support.

Where one person had support needs around their personal care and with their skin, their relative told us, “[Staff] check [person] for bruises and bed sores. They gave me the telephone number for the district nurse [to report any issues].”

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

People told us their consent was always sought, and they were involved in decisions about their care and support.One person told us, “[Staff] ask me for my consent about everything.” One relative told us, “We discuss [person’s] care with staff. I always hear [staff] asking for consent, for example, to be turned over or to go back to their room.” One staff member told us, “We always explain what we are doing and gain people’s consent.”

Where required, people’s records contained assessments of their capacity to understand and make decisions about their support. Where people did not have the capacity to understand and make decisions about their support, there were records of decisions made in their best interests.

Where applicable, care plans included information about people’s lasting power of attorney.