Maisy Care at Home 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.

This is the first assessment for this service since the location changed. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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.

The provider frequently updated and reviewed care planning documents which changed in line with people’s needs. For example, 1 person was supported through care planning that adapted responsively to their changing needs. The provider worked closely with healthcare professionals including dementia specialists and the people’s family to regularly review and update their care plan. One person told us, “Staff were really good at noticing small changes in me and helped me organise a GP assessment.” This meant the person’s needs were assessed regularly so that they received effective support when they needed it.

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.

Staff had completed nationally recognised specialist training for people with a learning disability and autistic people. Staff were positive about their training and felt it enabled them to better meet people’s needs. The provider had information about people’s specific health conditions from specialist nurses and used these when planning people’s support. This helped to ensure care was planned in line with current best practice guidance.

The manager told us they had access to good practice information through networking with other providers and from previous posts held within the national health service.

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 described effective communication within the team. Records of team meetings demonstrated a collaborative and reflective approach, where staff reviewed how care was delivered and identified areas for improvement. Comments from staff included: “[Manager] creates a positive and respectful working environment” and “As a team, we get on really well.”

Records showed staff had worked with dieticians to support people at risk of diabetes to maintain healthier lifestyles, and with the dementia nurse to improve staff knowledge and understanding. This had a positive impact on the care provided and enabled staff to better support relatives and people with information and guidance.

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.

Staff demonstrated a good understanding of people’s health needs and said they had the guidance they needed to provide effective support. Information about people’s health needs was reflected in their support plans. One person’s plan set out how to support them effectively to self-administer medicine with equipment. This resulted in the person being less dependent on staff and relatives. The person told us this was empowering for them.

Relatives told us and people’s care records demonstrated they had been supported to access relevant health services, including GP and specialist nurses.

The provider 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.

Feedback from people was positive. Comments included: “When I became ill, [manager] ensured additional support was put in place to support me”. The registered manager confirmed this and informed us even though the provider was not eligible for additional pay, they made sure the person was safe.

Staff maintained records of the care they had provided and observations of people. For example, people’s mental health or details of anxiety and distressed reactions. Records demonstrated changes were shared with health and social care professionals where needed.

The provider did not always tell people about their rights around consent but did respect these when delivering person-centred care and treatment.

The provider had systems in place to record people’s consent to care and treatment, and records showed that consent had been documented. However, practice did not consistently demonstrate compliance with the Mental Capacity Act (MCA) 2005. There were no mental capacity assessments in place to support decision-making for people where there were indicators they may lack capacity, and we found no evidence that less restrictive options had been considered or explored to uphold people’s rights and independence. For example, family members were making decisions for a person who lacked capacity.

Half of the staff we spoke with showed awareness of when people may require additional support to make decisions. Where there were concerns about a person’s capacity, staff told us they would report these concerns to the manager.

Despite consent being documented, the lack of formal capacity assessments and consideration of least restrictive options meant the provider could not fully demonstrate that people’s rights were consistently protected or that decisions were made in line with best practice.

However, the provider had referred people to advocacy- services to help them represent their views and support their involvement in decisions about their care.