Visiting Angels Northamptonshire

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 service since it was registered in April 2024. This key question has been rated Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (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 assessed people’s needs, but they did not always make sure the care, and treatment provided was safe and effective in relation to health care needs.

People’s needs were assessed before care commenced and reviewed whenever circumstances changed. People were involved in the assessment process to ensure important information about their communication needs, personal history, diversity, and family relationships was accurately documented. A relative told us, “The carers meet and understand [Person name] needs; they have been working with them for years, they know exactly what they like, and spoils them.”

People had a range of health conditions and required support with personal care, including moving and handling and delegated healthcare tasks. Records showed that relevant information and guidance had been obtained from health professionals to inform staff how to meet people's needs safely. Care plans included instructions for staff to follow and identified potential risks associated with delegated healthcare tasks. Staff told us if concerns arose regarding a person's delegated healthcare needs, they relied on the individual to contact their healthcare professional directly.

The provider did not always plan and deliver people’s care and treatment with them, in line with best practice and clinical guidance.

A relative told us, “The staff have all had the proper training. If there are new staff a nurse comes to train them.” Where the provider had undertaken a delegated healthcare task, they could not fully demonstrate that associated health risks were regularly assessed and monitored. Staff had received relevant training; however, competency had not been completed in line with the provider’s procedures. Although we found no evidence of harm, these concerns were discussed with the manager and provider who agreed to look at ways to improve this.

People and their relatives were positive about the care and support provided. Records showed evidence-based risk tools, such as the Malnutrition Universal Screening Tool (MUST) and the Waterlow score for pressure ulcers, embedded in the digital care system were regularly reviewed.

People's dietary needs were met, with staff supporting them to prepare food and drinks in accordance with their preferences and choices. A person told us, “Staff prepare my breakfast and heat up a ready meal for lunch” and added, “They always ensure I have enough fluids by my side.” Care plans included guidance for people requiring modified diets, and records confirmed that meals were prepared appropriately to meet their dietary needs.

The provider did not always work well across teams and services to support people. However, they did share people’s assessments and needs when they moved between different services.

There had been changes in leadership within the service; however, staff spoke positively about teamwork and said they felt well supported by their colleagues. Feedback about communication from leaders was mixed, with some staff reporting that communication was not always consistent and that queries were not responded to promptly. In addition, there were no effective oversight systems in place to monitor and ensure staff concerns and requests were addressed in a timely manner.

Staff told us they worked well together. Staff explained they were given information before they started caring for a new person.Established communication methods, such as group messaging, enabled important updates about people’s care to be shared in a timely way, helping to promote continuity of care and maintain people's safety.

Care records contained evidence of partnership working, with external professionals, to ensure people received timely and coordinated care. Feedback from professionals was generally positive and reflected effective collaborative working with the provider. One professional told us there was scope to strengthen working arrangements by ensuring the provider’s expectations and responsibilities were clearly defined and agreed when planning and delivering training.

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.

Leaders and staff ensured people were supported to maximise their independence, choice and control.

People were encouraged to make healthy lifestyle choices as part of their daily support. A relative told us, “[Person name] chooses what they want [to eat] but requires motivation, the staff are clever, amazing, in how they encourage them.” Another relative said, “They sit with [Person name] and ask what food, snacks and drinks they want and then send me the list so I can do their shopping.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it.

Systems were in place to monitor the care people received. People told us they were consulted about their care and support and that care plans were updated when their needs changed. Although records did not always clearly demonstrate people’s involvement in care planning, staff had a good understanding of individuals’ needs and the support required, helping to ensure care remained responsive and person-centred.

Staff recorded the care and support they provided and completed monitoring charts, such as food and fluid records, where required. However, there was limited evidence that the manager or provider regularly reviewed these records to identify changes in people's needs, risks, or staff practice. For example, we found occasions where medicines had not been administered and where staff had failed to log their arrival at a person's home despite alerts requiring action, with no evidence of follow-up. Although the digital care system included a communication function, this was not being used effectively. This indicated a lack of managerial oversight to identify and address issues in a timely manner.

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

People and relatives told us staff always asked for consent before they were supported. They told us they were involved in decisions made about their care which staff respected.

Staff had completed training in mental capacity and demonstrated an awareness of consent. They shared examples of how they gained consent from people when delivering care, and how they responded if someone refused care.

At the time of our assessment, everyone using the service had the mental capacity to make decisions about their care. The provider had procedures they would follow for people who lacked capacity. These included liaising with legal representatives and people’s relatives to help make decisions in their best interests.