Verity Healthcare - Haringey

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.

The service was in breach of legal regulation in relation to consent.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider completed initial assessments of people’s needs prior to the care package being agreed and commencing. The provider confirmed assessments incorporated information from people using the service, those acting on their behalf, professionals involved and the Local Authority. This was to ensure all information was captured depicting the care and support to be delivered by staff.

While some reviews of people’s support needs had occurred, it was not clear if these were routinely taking place. People and relatives spoken with told us, “I have never had a support plan review from Verity”, “They [Verity Healthcare – Haringey] did come out in person and check all was okay a while ago” and “I asked staff whether they were asked to report back on the progress [family member] was making but they said no. I kept thinking Verity Healthcare – Haringey would call to ask how the care was going and there would be some kind of survey at the end of the six week period. I’ve had no contact from them at all.” Following our assessment, the provider wrote to us and provided evidence of telephone monitoring calls to people using the service between February 2025 and August 2025. This included 3 out of the 6 people we reviewed as part of this assessment process. Additionally, a care plan review schedule for 2025, was forwarded to the Care Quality Commission. This showed 3 out of 6 people we reviewed as part of this assessment process had experienced a review of their support plan.

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.

Information viewed demonstrated the provider used evidence-based guidance and recommendations, from the National Institute for Health and Care Excellence [NICE]. For example, the provider applied suggested healthcare tools such as Waterlow to assess an individual's risk of developing pressure ulcers. There was also evidence of assessments by the Speech and Language Therapy teams [SALT] where a person was at risk of choking and experienced difficulty when swallowing. Guidance was also sought from the dietician service where a person had a Percutaneous Endoscopic Gastrostomy[PEG] feeding tube. A relative told us their family member received support from staff to follow exercises provided by the hospital physiotherapist, including a gentle walk in the afternoons. The examples provided above are part of a broader range of assessments and tools used by the provider.

Staff supported people as needed with the provision of meals, snacks, and drinks to ensure their nutritional and hydration needs were met.

The provider worked well across teams and services to support people.

Information demonstrated the service worked with others, for example, the Local Authority, healthcare professionals and services to support people’s ongoing care provision. For example, a person’s support plan included where others had input into their support and care, such asdietician and SALT. Staff told us they had the information they needed to support 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.

People had access to healthcare services when they needed it and confirmed their healthcare needs were met. For example, where people were living with the medical condition of Diabetes, there was evidence available to demonstrate, people had access to the local district nurse service, for the administration of their insulin and the on-going monitoring of their blood glucose levels. Information submitted by the provider following our assessment demonstrated the domiciliary care service had collaborated with an occupational therapist in relation to a person's mobility. Relatives confirmed staff were responsive to people’s healthcare needs and wellbeing. If staff were concerned about a person's health and wellbeing, they stated concerns would be relayed to the domiciliary care office for escalation and action.

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 the expectations of people themselves. Following our assessment the provider wrote to us and provided evidence of telephone monitoring calls to people using the service between February 2025 and August 2025. This included 3 out of the 6 people we reviewed as part of this assessment process. Additionally, a care plan review schedule for 2025, was forwarded to the Care Quality Commission. This showed 3 out of 6 people we reviewed as part of this assessment process had experienced a review of their support plan.

An electronic software system was being used by the provider for care planning. Staff used hand-held devices to access people’s care records and record the day-to-day support people received. However, not all people or their relatives were aware what was written about them and in some cases had to repeatedly vocalise to staff, the support and care to be provided to achieve positive outcomes. A relative told us, “I don’t know if they [staff] have a support plan to work to. I see they [staff] use an app on their phones, but I don’t know what is on it. I’ve had to train them [staff] all in what needs doing.”

Staff supported people as needed with the provision of meals, snacks, and drinks to ensure their nutritional and hydration needs were met.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and support.

The Mental Capacity Act 2005 [MCA] provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People’s capacity to make decisions were assessed, recorded and individual to the person and pre-assessments confirmed people or those acting on their behalf had consented to the provision of care to be provided by the domiciliary care service. However, 2 relatives spoken with confirmed consent forms were not completed prior to the commencement of the service. They told us they had been asked by the registered manager to sign and back-date a consent form relating to their family member’s support plan to the beginning of the support package. Both relatives confirmed they had refused to sign this as on review of their family member’s support plan, this did not accurately reflect their needs. Completing consent forms prior to providingcare and support is crucial for legal compliance, autonomy for the person using the service, and risk management. It ensures people and those acting on their behalf are informed and agree to the support to be provided, upholding their right to make informed choices and decisions. Another relative informed us that their family member was asked to sign a consent form stating they were happy for the domiciliary care service to provide the care, but a support plan had not been completed. Following our assessment the registered manager told us consent forms had previously been forwarded to relatives, but these were not completed and returned to the domiciliary care service in a timely manner.

Not all staff employed at the service demonstrated a good understanding of the MCA and how this involved and affected people using the service. For example, records viewed demonstrated staff were administering medication in a disguised form without the person’s knowledge or consent and were not following the best interest process. Staff had not informed the provider they were administering the person’s medicines covertly. Although the person lacked capacity to understand the need for the medication, the person’s care plan clearly recorded this task was to be conducted by a family member. The prescriber’s advice had not been sought to check if this method affected the medication’s efficiency and effectiveness. Justification for covert administration had not been formally agreed and documented. This is potentially unlawful and a breach of the person’s human rights. A relative told us that although their family member had capacity to effectively communicate and make day-to-day decisions, staff often liaised with them rather than with the person using the service. Speaking with the relative and not directly with the person does not uphold their autonomy.