Caremark Lewes and Wealden North

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 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People’s care and support needs were thoroughly assessed prior to them being supported by the service. Only if staff had the right training and experience would a person be taken on by the service. A relative told us, “They came and spoke with me and my family and explained what they could do for us. My partner has dementia so does not always fully engage but they were there and we explained everything.” People’s ability to understand the pre-assessment meeting was recorded within the care notes and every effort was made to explain the process to them. Care plans were reviewed every 6 months or more frequently if there was a significant event or illness for example if a person experienced a fall or required time in hospital. People and their loved ones were present for each review process.

The registered manager planned and delivered people’s care and treatment with them, including what was important and mattered to them. People were able to choose how they wanted their care and support provided. The registered manager made sure they were involved and were given choices. People could choose whether they wanted male or female carers and when was the most convenient time for carers to call. Staff responded to people’s needs and respected their wishes. Most people were independent with most aspects of daily tasks for example, taking a bath or shower however staff still needed to be close to keep people safe. Some people felt more comfortable with staff close and others wanted some privacy and this was respected within the confines of safety.

The registered manager 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. The registered manager had established positive working relationships with other health and social care professionals. People’s needs were met by a joined up approach to support. When people needed specialist support from for example, occupational therapists or the speech and language team, this was arranged by the service. Although hospital passports, a concise summary of people’s needs which could be passed to other professionals, was a work in progress, it was still possible for the registered manager to quickly provide that key summary of people’s medical history, key contacts and current presentation to those who needed it. A professional told us, “The handover they give us shows they know their clients very well, they inform us of any concerns they might have and advise if we need to refer to adult social care.”

The registered manager 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. Most people were either independent or had family support for their nutrition and hydration needs. Staff, however, were trained in food hygiene and were able to step in to help if needed. Some people lived with diabetes and staff were aware of appropriate dietary needs for people and what to do if a person was having a diabetic episode. A staff member told us, “We can and do step in and help people with food if needed. It’s about healthy choices and making sure they have what they can manage.” No one was currently receiving support from a speech and language therapist (SaLT) however all managers and staff were aware they could call on their support if needed.

The registered manager 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. Staff knew people well and were attentive to their health needs. Staff could tell if a person was feeling unwell or unsettled by their presentation and nonverbal expressions. When providing personal care staff would check for pressure sores or any other condition that might be causing the person distress. A relative told us that their loved one had developed a condition that was first noticed by the carers. The carers contacted the GP and secured moisturising creams to help. They then applied the creams and kept a record of the person’s condition to monitor their improvement. The relative said, “They are very good like that.” A member of staff told us, “You get to know the signs if people respond differently. Build a good rapport with people. Have brought this up with manager when there are changes.” When a person whose ability to mobilise was deteriorating, staff arranged with other professionals to get a bed positioned downstairs to make the person’s life easier.

The registered manager told people about their rights around consent and respected these when delivering person-centred care and treatment. Most people lived with varying capacity and therefore needed some support with day-to-day decisions to make sure they fully understood what was being proposed or suggested to them. Staff were aware of the importance of gaining consent from people before carrying out a task or activity. A member of staff told us, “It’s about how you word it. Maybe suggest a freshen up rather than a shower or bath. Some have had bad experiences in the past and it’s important not to rush or force people. I would always step back and re-think if someone said no.” Care plans highlighted the importance of consent and for each section of the care plan it was recorded that a person either gave consent or that the decision to consent was made in their best interest by a family member or a person qualified to make that decision.