Alina Homecare - Dorchester

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 newly registered service. 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.

People were supported to have consistent and effective care by staff and leaders. The provider had care needs assessment procedures to understand people’s needs and ensure they were able to meet them. People’s needs were comprehensively assessed and included consideration of their physical and mental health, sensory, social and communication needs. Tools were used to effectively support the assessment of people’s health and care needs, and those were used by staff with the right understanding and skills.

Assessments were regularly reviewed and updated to make sure information was current, and care and support was meeting people’s needs and individual outcomes as expected.

People and their relatives told us they were involved in care planning and regular reviews.

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 practice.

People’s care plans were developed holistically and included information and guidance from other professionals. Best practice guidance in relation to people’s specific support needs was understood and followed by staff. Staff recognised and responded promptly and adequately to people’s changing needs.

The service used recognised tools to assess people’s needs. Appropriate referrals to external services such as physiotherapy, dietitian or the community mental health team were made in a timely manner to make sure people’s needs were met. Staff told us how they monitored people’s nutrition and hydration where required, to manage specific risks to their well being. People were supported to achieve optimum nutrition and hydration, and their care plans outlined individual food and drink preferences. Systems were in place to monitor people's nutritional intake and weight, and risks associated with dehydration and malnutrition. Care plans identified the level of support people needed from staff to prevent malnutrition and dehydration, and any specific diets or food allergies. One relative told us, “The staff prompt [my loved one] to eat and drink at each visit and monitor their food in the fridge. On most days they take [my loved one] into the nearby village, and help [them] to choose food.”

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 worked collaboratively with other professionals such as district nurses, GPs, social workers and therapy teams to ensure people received well co-ordinated care which met their needs. The provider shared people’s care documentation with other professionals when needed and ensured any changes were communicated to staff. This meant people’s care was effectively coordinated, to ensure they received timely and consistent support and treatment.

When people moved between services, the provider took a person-centred approach and liaised with relevant professionals and health commissioners to ensure changes were documented and transitions were as smooth as possible. The provider established effective systems and processes for referring people to external services and to maintain continuity of care.

Monthly staff meetings were used to support communication and oversight within the service. Management held regular meetings to discuss people using the service, review care-related matters, and monitor any emerging risks or themes. Staff told us there was strong internal communication, mutual support during pressures and accessible managers. One staff member told us, “This company is the best company I have worked for in care regarding the amount of information on each service user.”

We received positive feedback from health and social care professionals about collaborative working.

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 were supported to access health professionals when needed. Staff knew to look for and escalate any concerns regarding people’s health so medical attention could be sought in a timely manner. Staff worked with other health and social care partners to prevent or reduce the need for admissions to hospital.

Care staff encouraged people to make healthy lifestyle choices such as increasing their physical activity or maintaining a balanced diet to promote their wellbeing. Some people had identified their own health goals such as improving their mobility which staff supported them to achieve.

Staff encouraged people to regain or maintain skills, for example after a health incident, by promoting activity and safe community access. One staff member told us, “I support a person who lost [their] confidence of going out in the community due to a fall. It is in the care plan to help with exercises to assist with walks to help build up [their] confidence so [they] can still go and do the activities [they] enjoy.”

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.

Staff monitored people's health and welfare and reported any concerns to the management team. Where needed, a member of the management team would make referrals to health care professionals. The manager told us they worked very closely with people, their relatives and health and social care professionals to ensure positive outcomes for them. Regular reviews were undertaken to ensure the focus was always on meeting people’s changing needs.

The provider took a holistic approach to outcomes and focused on supporting people to meet their communication and social goals. This gave people the opportunity to engage with the local community if they wished as well as meeting physical outcomes.

The provider actively sought feedback from health and social care professionals and stakeholders as appropriate when monitoring individual outcomes. Health and social care professionals we contacted confirmed this. Comments included, “The registered manager took great care with a complex client, and this included doing care visits [themselves] where required, and working with a high level of risk.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, principles of the Mental Capacity Act (MCA) were not fully understood and not always followed in line with the MCA assessment process. Documentation around consent was inconsistent.

People’s care plans contained information about their mental capacity and what support they required to make decisions. The management team and staff monitored people's mental capacity to ensure that they were able to make appropriate decisions, however this was not always effective.

Staff had received training in MCA but did not fully understand or always follow the principles of a best interest process.For example, we reviewed consent forms for 2 people which were signed by their legal representatives. However, mental capacity assessments were not completed to establish those people’s capacity to give their consent. We discussed this with the registered manager, and they took immediate action to rectify this.

People’s human rights were fully respected in practice. Staff told us they understood the importance of ensuring that people fully understand what they are consenting to and the importance of obtaining consent before they deliver care or treatment. People and relatives confirmed this. One relative told us, “Staff always explain what is happening and why. [My loved one] is always asked to consent.”

People and their relatives told us they were involved in their care decisions and staff respected those decisions. People were able to make day to day decisions about their lives. For example, they were supported to choose what they would like to eat or how to spend their time as they wished.