Balby Care and Home Services Ltd

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.

At our last assessment we rated this key question Good. At this assessment the rating has changed to 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 did not always make sure people’s care and treatment were effective. People’s needs were assessed prior to people starting the service and we saw evidence of regular reviews taking place. However, information in care plans and risk assessments required more detail to enable staff to understand people’s needs and to provide safe and effective care to people. We discussed this with members of the management team, who were aware of this shortfall and had plans in place to ensure improvement in people’s care plans and risk assessments. The service had recently employed a member of staff whose sole responsibility would be updating care plans and carrying out regular reviews of people’s needs.People gave mixed responses in relation to their involvement in care plans. One relative told us, “Yes, [family member] has a new care plan. The manager came about 6 weeks ago to discuss their care.” A person told us, “Yes I have my care plan, [staff] went through it with me.”However, another person told us, “No, I have no such document in my home.” A relative commented, “I have not been involved in any reviews for [family member].”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Care plan records regarding nutrition and hydration required improvement to ensure information highlighted risks and included person centred information. For one person, who required support with nutritional tasks, there was no detail within their care plan of meal preparation or what preferences the person had around their meals. People told us staff supported with ensuring sufficient food and fluid intake, with one person commenting, “[Staff] put dinners in the microwave, and whatever I ask for they will prepare.” However, during the inspection a relative submitted a complaint relating to the quality of their loved ones care. This was dealt with appropriately by the registered manager, who was responsive in addressing the concerns raised. However, this highlighted the improvement required to ensure people's needs were fully documented, in order to guide staff in delivering safe and effective care.

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 meetings and supervision sessions were in place to ensure staff were provided with current information to work together to support people. A staff member told us, “Yes, I do have supervision and appraisal. My manger is very supportive.” Documentation between staff and professionals were clear and concise and evidenced effective collaboration with professionals to ensure any health interventions were carried out in a timely manner.

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. The service supported people to access health care professionals and assisted people to attend those appointments. One relative told us, “When [family member] has a hospital appointment, [staff] will make sure they are there and get [family member] ready. They are good at things like that.” People told us the staff valued their independence and people were not rushed. One person told us, “[Staff] know what I can do for myself and allow me to do this.” Another relative commented, “Some mornings [family member] will say, ‘I don’t want to get out of bed’, but [staff] will encourage, give them a cup of tea and will get them dressed."

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. Information in some people’s care plans required improvement to ensure people’s health and well-being were being routinely monitored and risks for people were highlighted and managed effectively.

The provider told people about their rights around consent and respected these whendelivering person-centred care and treatment. Staff understood the importance of obtaining consent before delivering care and had received up to date training around the Mental Capacity Act (MCA). One member of staff told us, “We involve people in their care by explaining everything that we are going to do before doing it and get their consent on if this is okay. If they do consent, then while I am providing the care I will explain everything I am doing and keep asking if it is okay to carry on with the care” One person told us, “Some do get my consent. I don’t feel rushed.” However, the mental capacity assessments we reviewed required more detail around people’s cognition and ability to make decisions. Further information was also required on specific decisions.