Trinity Homecare (Worcester Park)

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 and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant people's outcomes were consistently better than expected compared to similar services. People's feedback described it as exceptional and distinctive.

This service scored 88 (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 was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Care workers confirmed that clear and comprehensive assessments were undertaken to identify people’s care and support needs. This was also echoed by people’s relatives. People and relatives were central to their assessment to ensure it reflected what they wanted to achieve from the service. One relative told us, “We had a full assessment. I was really taken by how kind they were. They listened to us and emphasised we would work together to get the best care plan for [my family member]. They talked to [my family member] a lot to find out what was important to them and to us.”

Care workers told us clear information was provided to them about how to care for people. A care worker said, “Someone from the office will call to talk us through a new call, and access arrangements.” Care staff, people and their relatives confirmed when people’s needs changed new assessments were undertaken to ensure care continued to meet their needs. Relatives told us, “We have reviews face to face 4 times a year and they are very thorough and go through everything and update everything. They are also very responsive to any requests on changes or times.” And “Reviews are done 3 monthly but they have said we can revise the care plan at any time.”

All the information gathered during the assessment process was clearly detailed in people’s care records to ensure this information was captured and made available to those involved in people’s care.

The provider planned and delivered people’s care with them, including what was important and mattered to them. They did this in line with legislation. The management team stayed up to date with best practice and delivered care and support in line with recommended guidance and recognised tools. People’s care and support plans included reference to best practice guidance and staff received regular training to ensure their knowledge and skill stayed up to date.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Staff worked with other services to ensure people received seamless care and support which met their needs. One person who lived in a particular setting wanted to change the environment they lived in so they could live in more comfort surrounded by their favourite personal belongings. Staff worked with other professionals to enable this to happen. Another person needed an environment that met their physical needs, but it was also important for them to be close to and to share their living surroundings with their partner. Again, staff worked with other professionals to enable this to happen. Staff worked with healthcare services to enable people to return to their own homes, where they wanted to be. This included supporting people to return home after being in a care home and also joint working with a hospice to enable a person to return home for their end-of-life support. Staff supported people when they were in hospital and ensured people’s communication needs continued to be supported and their needs and wishes were understood and respected. Collaborative working across services enabled people to have access to safe and effective care which respected their wishes and reflected what was important to them.

Care staff worked well together to provide a seamless service to people. Care staff enjoyed working as part of a team and used it as an opportunity to share learning. Comments from care workers included, “Teamwork has always been a strong and positive experience for me. We share responsibilities well and maintain open communication. I really enjoy meeting and working alongside other care workers, as it gives me insight into different approaches and techniques,” “I feel very lucky to be part of our team” and “My experience with teamwork has been very positive. We have a culture in Trinity that promote and fosters communication so most times the calls run seamlessly.”

The provider always supported people to manage their health and wellbeing to fully 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 knew the people they supported well and were able to quickly identify if people required additional support from healthcare professionals. Care staff supported people to live healthier lives and obtained health care advice promptly. A relative told us, “[The care worker’s] attention to detail is exceptional. They notice if anything is not quite right and if they think [the person] is not quite right they will call the doctor if necessary. They are very observant.” Another relative said, “A few weeks ago the care worker spotted an infection and spoke to the surgery. They managed to get an emergency medication pack to tide us over the weekend which meant it was dealt with before the infection took a strong hold.” One partner agency told us, “Communication has been timely and [staff member] in particular has always been pro-active in communicating any concerns to me.”

Staff were aware of people’s nutritional needs and supported them to have a healthy balanced diet. Care staff were aware of people’s eating habits. One person did not stay sitting at a table long enough to have a whole meal, but staff noticed they would snack as they walked around their home, so staff ensured snacks were easily accessible on the counter in the kitchen. Another person had been encouraged by their nutritionist to put on some weight, but they were happy with their meals and did not want to increase the amount they ate. Care staff worked with the person and healthcare professionals to agree how to approach this, and instead of increasing their meals, they had agreed to introduce protein drinks into their diet.

Care staff supported people to achieve their desired outcomes and improve their health and independence. Care staff took an advocacy role in coordinating and promoting people to achieve positive outcomes. A partner agency told us, “Trinity have been supportive of maintaining a patient’s protected mealtimes.They have taken on swallowing advice and have been pushing for the patient to have longer mealtime calls to ensure patient safety.”

The provider had a number of partnerships with other providers to further support people’s health. This included a partnership with a domiciliary optometrist and audiologist service, and staff had been trained to identify when someone’s hearing or sight deteriorated and they would benefit from additional support. The provider also had a partnership with another company supporting people, particularly those with dementia, to increase their hydration and fluid intake.

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

Staff supported people with their recovery, especially when people were receiving care after a long time in hospital. We saw examples, of where people had become stronger and fitter since receiving care. Staff supported people with their physiotherapy exercises and ensured they ate healthily. One person had successfully returned to a healthy weight and had become stronger. In turn their mobility had improved and there were now able to mobilise with less aids, improving their independence and access around their home and in the community. With the intensive support provided by live in care, people were able to achieve their desired outcome of staying at home for longer. We heard examples, of the gratitude people felt by having the right support at home from patient, positive care staff. This had enabled them to stay at home and give them the confidence and space to focus solely on their recovery.

The provider had tailored their electronic records systems to further support people’s health outcomes. Health monitoring forms had been developed and integrated into the electronic system to enable staff to track key indicators, such as pain, blood sugar, seizures, fluid intake, behaviour and mood. These could be adapted and added to if needed. This enabled staff to gather the required information prior to contacting health professionals or in liaison with health professionals to further track people’s need. For example, 1 person had recently been discharged from hospital and their GP had asked staff to monitor and track any signs of pain so they could use this information to establish if they required any pain medicines. For another person they were using both the pain tracking and behaviour tracking to establish if there were any triggers or patterns to when people exhibited behaviour that challenged, and whether this was linked to any pain.

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

Care staff were aware of their responsibilities to protect people’s rights and they adhered to the Mental Capacity Act 2005. People were provided with clear information which supported them to make informed decisions. This included information about the different types of care options available, as well as in regard to day to day decisions. One care worker told us, “People are involved in their care through shared decisions, making a person central to planning and having control over their choices.” Care staff understood people’s right to withdraw consent. A care worker said, “We understand that regardless of what they may have consented to in their care plans they have a right to refuse or withdraw consent at any time.” If people did not have the capacity to consent, staff liaised with those who were legally authorised to make decisions on their behalf. Details of these people were included in people’s care records.