Custom Home Care

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 people’s care, treatment 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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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. Care plans were person-centred and people were involved in developing and reviewing their care plans, however, there were some key elements missing from care plans including details about people’s communication preferences and needs, information specific to people’s learning disabilities and assessments of people’s capacity to make informed decisions. We raised this with the registered manager who agreed to take action. People and their relatives told us they were involving in planning their care. One person said, “The registered manger came round and explained everything to me and my daughter.” A relative said, “[The registered manager] sat with us for a good 3 hours and explained what they could provide. The care plan changed recently as [family member’s] condition has changed.”

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 provider worked closely with local health and social care organisations and ensured people received appropriate levels of care to meet their assessed needs. For example, a person’s care package was increased to 24-hour care for a period of time following a decline of their health. The staff team, in close contact with fast-track and continuing healthcare (CHC) teams, provided continuous monitoring, which led to a marked improvement in the person’s condition, including increased activity, better eating, and greater engagement and wellbeing.

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. Daily notes and updates were recorded in people’s care log which supported joined up communication between members of staff. Leaders attending local multi-disciplinary team meetings and safeguarding planning meetings and contributed to solutions agreed to improve outcomes for people.

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. There were systems and processes in place to record and monitor health information and outcomes for people. People’s care plans included information about interventions and support required to ensure people remained healthy. People were remined and supported to access GP and hospital appointments.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent and met both clinical expectations and the expectations of people themselves. The provider had a process in place to record and monitor people’s food and fluid intake. Daily notes and updates about the outcomes from people’s care and support was recorded in a care log.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. People and their relatives told us members of staff always asked for consent or permission before providing personal care. Members of staff explained what they were going to do and kept people informed. However, people’s care plans did not include reference to the Mental Capacity Act 2005 or record any assessments of people’s capacity to make informed decisions about consent to care and support. A person told us, “[Members of staff] always ask first, but they know my routine.” A relative said, “[Members of staff] are learning [family member’s] ways. They always ask them even if [family member] can’t understand, [members of staff] always talk [family member] through what they are going to do.”