Becoming Care Services Limited

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 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.

Prior to a person starting to receive care from the service, an assessment of their needs was completed. This helped to ensure that the service had staff suitable to provide the care and the service understood the needs of people. People confirmed they were aware they had a care plan. A person told us, “The director discussed what was needed with the hospital staff while I was still hospitalised before the care package started.” A relative told us, “When we were first referred [management name] sat with us and asked all these questions. If I want to, I could see the care plans.”

The registered manager told us, “We aim to have a care plan completed in a week or 2. Some care plans are constantly changing because the carer is reporting back to us, others reduce as the person gets better, as we have some short-term care packages.”

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 registered manager used their electronic care planning system to develop people’s care planning in line with national guidance. This included assessments such as Waterlow (assessing people’s skin integrity risk). This helped identify any specific risks for people.

The system had standard assessment tools which the registered manager adapted to each person, depending on their needs. Staff had full access to the care planning system through handheld devices, so they were able to pick up on any changes made.

Where people required support with their meals, staff encouraged people to eat healthy and well-balanced foods and to maintain regular fluid intake. One person told us, “They are competent, and they also assist me with shopping and meal preparation.” A staff member said, “Some people want to eat on their own, so I encourage them and try to boost their confidence.”

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.

Staff worked well together across the area covered by the service so that people who required 2 staff to attend to their care received this. People confirmed this was the case telling us that it was always 2 staff who supported them. The registered manager had dedicated drivers who transported staff, which helped ensure that people’s care calls were carried out as close as possible to the expected time. The registered manager liaised with people’s GPs or the district nursing team to arrange healthcare input when people required it.

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 plans held information about their health and care needs to support staff to provide the most suitable and appropriate care. This included where people required support with their mobility or were cared for in bed and required 2 staff to reposition them.

If people became unwell or staff were concerned about a person, their GP was contacted and their family informed, so they could receive healthcare input if required.

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 people themselves.

Although there was information in people’s care plans to help staff monitor a person, it was not always clear how this was carried out in practice. For example, 1 person’s care plan stated, ‘my weight and nutritional status remain stable’, but there was no indication of how the registered manager knew this, as the person was not being weighed regularly and staff were not recording the person’s food intake. Another person’s care plan stated, ‘maintain accurate food and fluid records,’ but there was no evidence that this was being done.

However, other people had positive outcomes from the support they received from staff. This included 1 person who went from being cared for in bed to walking, which enabled them to move back into their bedroom. Other people’s calls were reduced from 4 a day to 1 as their health improved and they became more independent. One person told us, “They assist in helping me carry out exercises as prescribed by the physiotherapist.” A relative said, “The carers have really helped her in becoming better. They’ve all been consistent and helpful. [Family member] said they keep her happy and make her laugh.”

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

No one currently receiving care from the service lacked the capacity to make decisions about their care, and therefore, mental capacity assessments had not been completed which meant the service was following the requirements of the Mental Capacity Act (2005) (MCA).

Staff, however, had received training on the MCA to help ensure they had a good understanding of its principles. The registered manager told us, “People may have capacity on certain things, but not on others.”

People said the staff asked for their consent. One person told us, “[Member of staff] never forces anything on me. It’s an excellent relationship on so many levels.” A relative said, “We’ve had trainees come in with the senior, but they always take our permission first.”