Harborough Home Care Limited T/A Bridgewater Home Care - Harborough Also known as Bridgewater Home Care - Harborough

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 79 (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 relatives informed us their family members needs were regularly reviewed, which meant the care and support provided was up to date and reflective of their current needs. A relative told us, “Staff come every 3 months to see about any changes and to check everything is still alright.”

People and, where appropriate, their relatives were fully involved in the assessment process. Following the initial introductory meeting a full assessment of the person’s needs was undertaken, which focused on people’s health, care, well-being and communication needs. People were asked as to what was important to them and their daily lives, what their expectations of the service were, including areas to improve or maintain their health, wellbeing and independence with the support of staff from the service. The assessment identified people’s views as to the frequency and duration of care visits in meeting their expectations and needs.

The registered manager and managing director spoke passionately of their commitment in providing a high quality and tailored service to meet people’s individual needs.

An initial monthly review was undertaken with the involvement of all parties to identify how the package of support was being received and determine if any changes were required. People’s packages of care were kept under review, with the full involvement of the person supported by the registered manager’s oversight of care records and staff feedback which identified any changes in people’s needs, health of well-being.

The registered manager spoke of their continuous approach of auditing and monitoring people’s care records, focusing on key areas such as mobility, nutrition and social interactions to identify if the support provided could be enhanced to improve people’s experiences and outcomes.

Staff confirmed people’s care needs were regularly reviewed and any changes were made to people’s care plans where required. Staff informed the registered manager of any changes in people’s care so as they could update the appropriate care records.

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.

People’s relatives told us their family members dietary needs were met, which included serving food in a style to meet their needs. A relative told us, “Staff do cut up the food if necessary.” A relative spoke of the action staff took to ensure their family member ate, they told us, “If she doesn’t eat, they come round later, and she generally eats’ then, which is really good of the staff.”

Staff were aware of people at risk of malnutrition or dehydration. A member of staff told us, “I support a person who is underweight, and as well as careful monitoring we have to ensure they are given calorie dense meals and lots of snacks between meals. We have to make sure we don’t push too much, so as the person maintains a healthy relationship with food.” Another member of staff spoke of a person who had difficulties with swallowing, and how they cut off the crusts of toast to they could still eat what they enjoyed as safely as possible.

The registered manager and managing director recognised the importance of using assessment tools in line with legislation and current evidence-based practice and standard. For example, assessing and monitoring people at risk of malnutrition and dehydration.

Staff supported people with grocery shopping where required to do so and helped people in preparing meals and snacks as part of some people’s package of care and support.

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 people moved between different services.

People’s relatives spoke of effective communication between themselves, staff and other services involved in their family member’s care. A relative told us, “Staff called the district nurse when they spotted a cut on his arm.” Relatives spoke of how they informed them of any issues so as they could take the appropriate action. A relative said, “Staff spotted a red mark on her, and told me, as I make the appointments.”

Staff consistently spoke of comprehensive assessments and care plans which provided clear information as to people’s needs. They spoke of effective communication between each other, the registered manager and managing director which enabled them to meet people’s needs.

The registered manager spoke of how they worked in collaboration with people’s GP’s, specialist nurses and wound care specialists where required. Collaboration with hospital-based staff ensured people’s discharge from hospital was managed safely to ensure the commencement of a person’s package of care coincided with the time and date of their returning home.

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 relatives spoke overwhelmingly of the positive impact the service had on them and their family members’ life, and of the impact on their wellbeing. A relative shared how staff supporting their family member to attend a day care service, which impacted on both their lives. They told us. “Staff drive her to [day centre], this is hugely beneficial for both of us. She gets lots of great mental stimulation as they encourage her both verbally and physically, and I get respite and an hour or so to myself.”

Staff were aware of the importance of monitoring and recording any changes in people, which included changes in mobility, behaviour or mood, fluid and food intake, and how such changes were recorded and escalated.

The registered manager and managing director spoke passionately as to the ethos of the service being to facilitate people remaining in their own homes, by encouraging and supporting them to maintain, and where practicable, increase their independence. The feedback we received from relatives confirmed the ethos of the service had been effective in enabling their family members to remain at home, with the support and care of staff. A relative told us, “Staff are great, they help him and me, by getting him in and out of bed and washing him, which takes enormous pressure off me.”

Assessments of people’s needs identified people’s preferences, routines, dietary needs, hobbies and interests, and mobility needs, which were used to develop a package of care and support to facilitate and enable people to remain at home, maximising independence and choice.

The registered manager spoke of their continuous approach of auditing and monitoring people’s care records, focusing on key areas such as mobility, nutrition and social interactions to identify if the support provided could be enhanced to improve people’s experiences and outcomes.

People and family members maintained their independence in organising and attending health care appointments and were supported by staff where required.

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

People’s relatives were consistent in their praise of staff in meeting both their and their family members expectations, which achieved positive outcomes for all. A relative told us, “The carers and this company are marvellous. We’re both in our 90’s and following a bad fall, I was unable to wash or dress him, so they come in, wash and help him dress, whilst encouraging him to dress himself. They clean up and even iron his shirts. He was bed bound, but now with their help is no longer bed bound, and even take him for walks now.”

Staff demonstrated a good knowledge of people’s health care needs and conditions and fully understood their role in management and oversight. For example, a member of staff recorded the blood sugar levels regularly provided by an arm monitor of a person living with diabetes. The member of staff was aware of how to escalate any concerns with the person’s relatives and health care professionals and knew the action to take if the person’s blood sugar readings were too low or too high. For example, offering something sweet to a person with low blood sugar levels. A member of staff spoke about a person they supported. They told us, “Health care monitoring is part of the everyday work, recording and reporting our findings. If you find someone deteriorating, you report it so it can be passed on. If I informed the office about someone’s breathing deteriorating, they would inform the respiratory nurse or GP”

Both the registered manager and the managing director maintained oversight of the provider’s data management system, which enabled them to keep under review people’s needs, and adjust the package of care in response to any changes.

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

People’s relatives confirmed staff always sought their family members permission prior to providing any support or care. A relative shared how they overheard staff talking with their family member both seeking consent and encouraging independence. They told us, “Staff always ask, I hear them saying ‘Shall we wash you now, or do you want to try and do it yourself’, everything is fully tailored to his needs.”

The registered manager emphasised the importance of people having autonomy in decisions relating to their care and support. This included ensuring people’s communication needs were fully understood, so they could be considered and planned for when discussing their needs and expectations of the service. As part of a persons assessment, a ‘Consent to Care’ form was completed and signed by the person. In circumstances where a person was identified as not having capacity to consent to their care, a Best Interest decision would be made, involving their relative or others involved in their care, with consideration being given where a person held a lasting power of attorney in health and welfare decisions.

The provider understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires, that, as far as possible, people make their own decisions and are helped to do so when needed. Where people lack mental capacity to make particular decisions, any made on their behalf must be in their best interests, and as least restrictive as possible.